3rd International AIDS Society Conference on HIV Pathogenesis and Treatment Rio de Janeiro - July 24 - 27, 2005

SHIFT FROM PROTEASE INHIBITOR- TOWARDS NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITOR-BASED HAART VERSUS LIPID-LOWERING TREATMENT, FOR THE MANAGEMENT OF HAART-RELATED DYSLIPIDEMIA

IAS Conf HIV Pathog Treat 2005 Jul 24-27;3rd: Abstract No. TuFo0105

Calza L., Manfredi R., Colangeli V., Tampellini L., Sebastiani T., Pocaterra D., Chiodo F.
University of Bologna, Bologna, Italy

INTRODUCTION: Hypertriglyceridemia and/or hypercholesterolemia are the main tolerability concerns of protease inhibitor-based HAART, since they are associated with the development of serious cardiovascular events in proportionally young HIV-infected patients. Aim of our study is to evaluate simplified protease inhibitor-sparing antiretroviral treatment versus added lipid-lowering therapy for the management of HAART-induced hyperlipidemia.

METHODS: A randomized, open-label clinical trial assessing the efficacy on hyperlipidemia of a switching therapy from protease inhibitors to non-nucleoside reverse transcriptase inhibitors (nevirapine or efavirenz) versus a hypolipidemic treatment (containing either pravastatin or bezafibrate) added to current, unchanged protease inhibitor-based antiretroviral combination, was carried out at our centre. All HIV-infected patients on their first HAART regimen, with stable immunological-virological features, naïve to all non-nucleoside reverse transcriptase inhibitors, and with mixed hyperlipidemia, were randomized to replace protease inhibitors with nevirapine (arm 1) or efavirenz (arm 2), or to receive pravastatin (arm 3) or bezafibrate (arm 4) with unchanged HAART regimen, and were followed-up for 12 consecutive months.

RESULTS: One hundred and thirty patients were evaluable at this time: 29 patients were randomized to arm 1, 34 to arm 2, 36 to arm 3, and 31 to arm 4. At the end of the established 12-month follow-up, a reduction of 25.2%, 9.4%, 41.2% and 46.6% in mean triglyceridemia versus respective baseline values was reported in groups 1, 2, 3, and 4, respectively, with statistically significant difference between arms A-B and C-D (p<.01). Comparable results (p<.01) were reported when analyzing the trend of both total and LDL-cholesterol levels. Both virological-immunological efficacy and the comprehensive tolerability profile were comparable in all considered study arms.

CONCLUSIONS: Pravastatin and bezafibrate proved significantly more effective in the management of HAART-related hyperlipidemia, than the switching therapy from a protease inhibitor-based regimen, toward a nevirapine- or efavirenz-based one. Further studies are needed to elaborate guidelines for pharmacological management of HAART-associated hyperlipidemia.

Download PDF of this abstract.

050724
TuFo0105
Complications of HIV therapy

Copyright © 2005 - International AIDS Society (IAS). All information and content relating to the abstracts from the 3rd International AIDS Society Conference on HIV Pathogenesis and Treatment, such as text, graphics, logos, button icons, images, audio clips, and software is protected by copyright. Permission is hereby granted for the non-commercial use or reproduction of the information on this web site, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.

AEGiS is made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2005. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2005. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. Permission is hereby granted for the non-commercial use or reproduction of the information herein, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.