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

LIPID PROFILE IN HIV-POSITIVE PATIENTS WITH HAART-RELATED HYPERLIPIDAEMIA

Antiviral Therapy 2000; 5(Suppl. 5):28 (abstract no. P7)

T Garcia-Benayas, F Blanco, A Barrios, J de la Cruz, MJ Senchordi, J Sánchez, V Sorlano and J Glez-Lahoz
Instituto de Salud Carlos III, Madrid, Spain

BACKGROUND: Dyslipidaemia is a frequent metabolic abnormality in HIV-positive patients on HAART. Although PIs have been suspected to play a major role, other antiretroviral drugs, such as NRTIs and NNRTIs, could be implied as well.

OBJECTIVES: To describe the lipid profile in a group of HIV-positive subjects with HAART-associated hyperlipidaemia and its relation to the different drug regimens prescribed.

DESIGN: Cross-sectional study of 201 HIV-positive patients under HAART with hypercholesterolaemia (HC; cholesterol >200 mg/dl) and/or hypertriglyceridaemia (HT; triglycerides [tg] >200 mg/dl). Lipid levels were recorded after at least 3 months on one of the following combinations: NRTI+NNRTI, NRTI+PI, or NRTI+NNRTI+PI.

RESULTS: Mean age 40±8 years, male 82%. Mean CD4 count 565±285 cells/mm³ (23±8%), undetectable VL (<50 copies/ml) in 65%. HC was present in 85% (mean cholesterol value, 265±43 mg/dl) and HT in 64% (mean tg value: 424±251 mg/dl; P=0.001). Both HC and HT were present in 58%. Within each antiretroviral regimen (1: NRTI+NNRTI; 2: NRTI+PI; and 3: NRTI+NNRTI+PI), percentage of patients on treatment and mean lipid values were: 46, 33 and 21%, respectively; cholesterol 258±44, 254±47 and 276±61 mg/dl, respectively; and tg 310±243, 309±l74 and 438±339 mg/dl, respectively. A trend towards higher lipid levels in the group with NRTI+NNRTI+PI was observed, being statistically significant for the differences for mean cholesterol levels between regimens 2 and 3 (P=0.036) and for mean tg levels between regimens 1 and 3 (P=0.015).

CONCLUSIONS: In HIV-positive subjects under HAART with dyslipidaemia, hypercholesterolaemia is more prevalent than hypertriglyceridaemia, although both are present in more than half of patients. No differences between NNRTI and PI-based regimens were found. However, the NNRTI+PI combination was associated with higher cholesterol and triglyceride levels than regimens containing either NNRTI or PI. This fact may be due to a synergistic effect of these drugs on the lipid profile.

000913
P7

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