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1st International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV26–28 June 1999 - San Diego, CA, USA |
FACTORS INFLUENCING THE EVOLUTION OF PLASMA TRIGLYCERIDE IN THE ERA OF HAART, AQUITAINE COHORT, 1996-1998
Antiviral Therapy 1999; 4(Suppl. 2):40 (abstract no. 015)
R Thiébaut1,2, D Malvy1,2, P Mercie2,3, V Daucourt1,3, C Marimoutou1,3 and F Dabis1 for the Groupe d'Epidemiologie Clinique du Sida en Aquitaine1,3 (GECSA)
1INSERM U330, Université Victor Segalen Bordeaux 2, Bordeaux; 2Service de Médecine Interne, Centre Hospitalier Universitairede Bordeaux; and 3CISIH, Centre Hospitalier Universitaire de Bordeaux, France
BACKGROUND: Since HAART became available, hyperlipidaemia has been one of the most common metabolic side effects of protease inhibitors (PI). The influence of other factors on plasma triglyceride (TG) is not known.
OBJECTIVES: To examine factors associated with TG in a multirisk cohort of both genders with multiple antiretroviral (ARV) regimens.
DESIGN: Repeated measure analysis (mixed model) in a cohort of HIV-1-infected patients followed in south-western France between 1996 and 1998.
RESULTS: 1825/3230 Patients followed in 1996-1998 had two or more available measures of TG. Patients included were comparable with others for gender and AIDS stage and were more frequently homosexuals (P=0.02). The median duration of follow-up was 22 months [interquartile range (IQ)10-28 months]. Fifty percent of patients had six or more measures of TG (IQ 3-9). Among the 11897 available observations, 6422 (54%) were during treatment with PI, 4692 (39%) during ARV treatment with other drug combinations and 783 observations (7%) in the absence of ARV treatment. Initial descriptive model showed an increasing trend of TG over time (+1.03 mmol/l/100 days). Univariate analysis demonstrated an increase of baseline TG with age (+1.01 mmol/l for 1 year older), with CD4 cell count at the first measurement (+0.7 mmol/l for 100 cells/mm3 higher), male gender (+1.19 mmol/l), homosexual HIV transmission group (+1.16 mmol/l). Similarly, AIDS occurrence, PI treatment and nucleoside analogue treatment increased TG during follow up: +1.24 mmol/l, +1.21 and +1.06, respectively. Compared with no PI, ritonavir (+1.83 mmol/l), nelfinavir (+1.19), indinavir (+1.11) and association of two PIs (+1.54) were associated with an increase of TG whereas saquinavir was not (-1.0 mmol/l). In multivariate analysis, gender, age, AIDS stage and PI remained associated with the evolution of TG (P>0.001).
CONCLUSIONS: As reported before the era of HAART, AIDS stage is associated with an increase of TG as with male gender and age. We confirm also the increase of TG with PI. Adjusting for PI use, nucleoside analogues are not significantly associated with TG.
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Copyright © 1999 - International Medical Press Ltd. Reproduction of this abstract (other than one copy for personal reference) must be cleared through the Medical Editor, International Medical Press, 36 St Mary-at-Hill, London EC3R 8DU, United Kingdom.