1st International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV 26–28 June 1999 - San Diego, CA, USA

EFFECT OF FENOFIBRATE ON HYPERLIPIDEMIA IN HIV-INFECTED PATIENTS

Antiviral Therapy 1999; 4(Suppl. 2):58(abstract no. 44)

D Lee, WC Mathews, S Hsia, S Basinger and E Barber
University of California, San Diego Medical Center, San Diego, California, USA

BACKGROUND: Fenofibrate (proprietary name TriCor) is a known antilipemic agent which has been effective in treating lipid disorders associated with high levels of serum triglycerides and VLDL. It has not been studied in HIV populations.

OBJECTIVES: To evaluate whether fenofibrate is effective in treating hyperlipidaemia in HIV-infected patients.

DESIGN: We retrospectively analysed laboratory records of eight HIV-infected patients initiating fenofibrate therapy for hyperlipidaemia between 26 June 1998 and 3 May 1999 from an outpatient HIV clinic (Owen Clinic). We compared triglyceride and cholesterol levels prior to initiation of fenofibrate with those recorded at the most recent visit while still on therapy. Paired t-test and Wilcoxon signed-rank test were used to compare (i) the change in lipid levels (pre-post) and (ii) the change in triglyceride and cholesterol levels per 100 days of fenofibrate therapy.

RESULTS: Patient characteristics: all male, mean age 45 years (29-65), 12% non-Caucasian, median CD4 cell count 331 cells/mm³ (41-416), median log₁₀ RNA 2.88 (2.60-4.79), median body mass index 24.1 (23.0-36.9). Mean absolute decline in triglyceride levels was 611 mg/dl [two-tailed P value of 0.08 (paired t-test) and 0.01 (Wilcoxon)]. Mean rate of decline of triglycerides was 381 mg/dl per 100 days on fenofibrate. Mean absolute decline in cholesterol levels was 50 mg/dl [two-tailed P value of 0.04 (paired t-test) and 0.06 (Wilcoxon)]. Mean rate of decline of cholesterol was 53 mg/dl per 100 days on fenofibrate. Mean and median times on fenofibrate were 159 and 163 days (31-251), respectively.

CONCLUSIONS: (i) Fenofibrate may be useful in the treatment of both hypertriglyceridaemia and hypercholesterolaemia in the HIV population. Further prospective studies are needed to evaluate the safety, efficacy and drug interactions of fenofibrate in this population.

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