Substituting abacavir for hyperlipidemia-associated protease inhibitors in HAART regimens improves fasting lipid profiles, maintains virologic suppression, and simplifies treatment
| Autor: | Edwin DeJesus, Jerry W Snidow, Anne Shachoy-Clark, Vanessa C. Williams, John H Wakeford, Jaime E. Hernandez, Michael Sension, Allan Rodriguez, Philip Keiser, Gary E Pakes, Jeffrey F Olliffe, Julie W Fleming |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male Anti-HIV Agents medicine.medical_treatment HIV Infections Hyperlipidemias Pilot Projects Pharmacology Biology lcsh:Infectious and parasitic diseases law.invention chemistry.chemical_compound Randomized controlled trial law Abacavir Antiretroviral Therapy Highly Active Hyperlipidemia medicine Humans HIV Protease Inhibitor lcsh:RC109-216 Least-Squares Analysis Triglycerides Protease Cholesterol virus diseases HIV Protease Inhibitors Middle Aged medicine.disease Lipids Virology Dideoxynucleosides Regimen Infectious Diseases chemistry HIV-1 Reverse Transcriptase Inhibitors Female Viral load Research Article medicine.drug |
| Zdroj: | BMC Infectious Diseases, Vol 5, Iss 1, p 2 (2005) BMC Infectious Diseases |
| ISSN: | 1471-2334 |
| DOI: | 10.1186/1471-2334-5-2 |
| Popis: | Background Hyperlipidemia secondary to protease inhibitors (PI) may abate by switching to anti-HIV medications without lipid effects. Method An open-label, randomized pilot study compared changes in fasting lipids and HIV-1 RNA in 104 HIV-infected adults with PI-associated hyperlipidemia (fasting serum total cholesterol >200 mg/dL) who were randomized either to a regimen in which their PI was replaced by abacavir 300 mg twice daily (n = 52) or a regimen in which their PI was continued (n = 52) for 28 weeks. All patients had undetectable viral loads (HIV-1 RNA Results At baseline, the mean total cholesterol was 243 mg/dL, low density lipoprotein (LDL)-cholesterol 149 mg/dL, high density lipoprotein (HDL)-cholesterol 41 mg/dL, and triglycerides 310 mg/dL. Mean CD4+ cell counts were 551 and 531 cells/mm3 in the abacavir-switch and PI-continuation arms, respectively. At week 28, the abacavir-switch arm had significantly greater least square mean reduction from baseline in total cholesterol (-42 vs -10 mg/dL, P < 0.001), LDL-cholesterol (-14 vs +5 mg/dL, P = 0.016), and triglycerides (-134 vs -36 mg/dL, P = 0.019) than the PI-continuation arm, with no differences in HDL-cholesterol (+0.2 vs +1.3 mg/dL, P = 0.583). A higher proportion of patients in the abacavir-switch arm had decreases in protocol-defined total cholesterol and triglyceride toxicity grades, whereas a smaller proportion had increases in these toxicity grades. At week 28, an intent-to treat: missing = failure analysis showed that the abacavir-switch and PI-continuation arms did not differ significantly with respect to proportion of patients maintaining HIV-1 RNA Conclusion In hyperlipidemic, antiretroviral-experienced patients with HIV-1 RNA levels 500 cells/mm3, substituting abacavir for hyperlipidemia-associated PIs in combination antiretroviral regimens improves lipid profiles and maintains virologic suppression over a 28-week period, and it simplifies treatment. |
| Databáze: | OpenAIRE |
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