Improvement in lipid profiles over 6 years of follow-up in adults with AIDS and immune reconstitution
| Autor: | Rob Roy MacGregor, David Ragan, Jeff Schouten, Susan Cahill, Ilene Wiggins, Judith Feinberg, Kathryn Maffei, Paige L. Williams, Judith S. Currier, Christine M. Fietzer, Charlene Gaca, Kathy J. Watson, Sandra Valle, Robert A. Salata, Lisa Kessels, James P. Steinberg, Mitchell Goldman, Jody Lawrence, Graham Ray, Tammy O'Hara, Susan L. Koletar, Janet Forcht, Clifford J. Gunthel, Julie Hoffman, William A. O'Brien, J. A. McCutchan, Charles van der Horst, Mark Rodriguez, Charlotte Mills, Charles Gonzales, Robin Worrell-Thorne, Mary M. Payne, Ellen Chusid, Robert L. Murphy, Joan Riddle, Sheryl S Storey, Julia W. Wu, Jane Reid, Beth Zwickl, Jane L. Norris, Gerianne Casey, Rebecca Clark, Henry H. Balfour, Mallory D. Witt, Kathleen Squires, Oluwatoyin Adeyemi, Sadia Shaik, Marshall J. Glesby, Susan E. Cohn, Valery Hughes, Pualette MacDougall, Bev Putnam, Walter Weiss, Harold A. Kessler, Ericka Patrick, Timothy Cooley, Patricia Galloway, Donna Mildvan, Tammy Powell, John McNeil |
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| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Adult
Cyclopropanes Male medicine.medical_specialty Efavirenz Blood lipids Coronary Disease Hyperlipidemias Article chemistry.chemical_compound Pharmacotherapy Immune reconstitution inflammatory syndrome Immune Reconstitution Inflammatory Syndrome Internal medicine Hyperlipidemia Medicine Body Fat Distribution Humans Pharmacology (medical) Hypolipidemic Agents Metabolic Syndrome Acquired Immunodeficiency Syndrome business.industry Cholesterol Health Policy Middle Aged medicine.disease Benzoxazines Infectious Diseases Treatment Outcome chemistry Anti-Retroviral Agents Cardiovascular Diseases Alkynes Immunology Ritonavir Drug Therapy Combination Female Metabolic syndrome business Epidemiologic Methods medicine.drug |
| Popis: | Objectives The aim of the study was to evaluate long-term changes in lipids and to assess other coronary heart disease (CHD) risk factors in highly experienced AIDS patients with immune reconstitution, and to examine their association with antiretroviral therapy (ART). Methods We evaluated 433 AIDS patients with prior severe immunosuppression and ART-based immune reconstitution, followed in a multicentre prospective observational study between 2000 and 2006. We estimated the prevalence at entry of hypercholesterolaemia and metabolic syndrome, and 10-year CHD risks. Trends in total cholesterol (TC), triglycerides (TG) and high-density lipoprotein (HDL) cholesterol were evaluated over time, and use of specific ART drugs at each study visit was assessed using mixed effect models, adjusting for CHD risk factors and use of lipid-lowering agents. Results At entry to observational follow-up, 28% of the 433 subjects had hypercholesterolaemia and 15% had a predicted 10-year CHD risk above 20%. Average TC and fasting TG levels declined over the follow-up period (median=5.8 years), and these declines were associated with increased use of physician-prescribed lipid-lowering agents and changes in ART regimens. After adjustment for CHD risk factors, TC and TG levels were significantly higher for those on ritonavir-boosted protease inhibitors and those on nonnucleoside reverse transcriptase inhibitors (NNRTIs), particularly efavirenz, than for other patients. Conclusions Abnormalities in serum lipids were common at baseline but became less so over time, and this improvement was associated with increased use of lipid-lowering agents and selection of ART agents with less deleterious effects on lipids. |
| Databáze: | OpenAIRE |
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