2nd International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV 13-15 September 2000, Toronto, Canada

EFFECTS OF EFAVIRENZ ON LIPID METABOLISM IN NAÏVE AND PROTEASE INHIBITOR-EXPERIENCED HIV-POSITIVE PATIENTS

Antiviral Therapy 2000; 5(Suppl. 5):30 (abstract no. P10)

G Ravasi, G Meneghetti, G Barasolo, E Seminari, S Novati, R Gulminetti and R Maserati
Infectious Disease Clinic and Department, Pavia, Italy

BACKGROUND: Metabolic alterations are common side-effects during HAART therapies containing protease inhibitors (PIs). The switch from PIs to nonnucleoside reverse transcriptase inhibitors (NNRTIs) has been attempted to control these side-effects.

OBJECTIVES: To evaluate levels of triglycerides and cholesterol in naïve and in experienced patients switching from a PI-based to an NNRTI-based HAART containing efavirenz.

METHODS: Determination of triglyceride and cholesterol plasma levels at fixed time-points (1, 3 and 6 months) in HAART-treated patients.

RESULTS: Eighteen naïve patients (16 male, two female) who began an efavirenz-based HAART (12 plus didanosine and lamivudine; four plus stavudine and lamivudine; two plus zidovudine and abacavir) were enrolled. Baseline pVL of 157,642±153,774 dropped to <50 copies/ml in 16/18 patients after 6 months. Mean triglyceride baseline level of 169±112 mg/dl remained stable (month 1: 131±43; month 3: 176±104; month 6: 189±100). The cholesterol values showed a slight but not significant increase from baseline to 6 months (baseline: 193±37; month 1: 194±43; month 3: 197±40; month 6: 211±37). Twenty PI-experienced patients (18 male, two female), were evaluated. Baseline triglyceride mean value was 180±43 mg/dl, cholesterol was 172±35 mg/dl. In the 12 PI-experienced patients who switched to efavirenz because of metabolic abnormalities triglyceride levels dropped from 369±91 mg/dl (baseline) to 288±188 mg/dl (month 1), 295±91 mg/dl (month 3), 224±43 mg/dl (month 6) (P<0.05). Cholesterol plasma levels did not significantly differ from baseline (228±75 mg/dl) at 6 months (224±51 mg/dl). In the eight PI-experienced patients who switched to efavirenz because of viral rebound, both values did not significantly change from baseline (triglyceride: 204±53 mg/dl; cholesterol: 186±57 mg/dl) to 6 months (triglyceride: 206±41 mg/dl; cholesterol: 217±42).

CONCLUSIONS: Treatment with efavirenz was not associated with metabolic abnormalities during a 6-month follow-up. In PI-experienced patients switched to efavirenz because of metabolic abnormalities a significant reduction in triglyceride levels was observed.

000913
P10

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