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4th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV22-25 September 2002, San Diego, CA, USA |
HIGHLY ACTIVE ANTIRETROVIRAL THERAPY WITH EFAVIRENZ: LONG-TERM METABOLIC EFFECTS
Antiviral Therapy 2002; 7:L32 (abstract 46)
B Roca, JA Ferrero, JM Marco and C Lapuebla
Hospital General of Castellon, Castellon, Spain
BACKGROUND: Metabolic side effects, such as hyperglycaemia and hyperlipidemia, are probably less common with efavirenz than with other antiretrovirals. However, information about these toxicities is limited, and more data are needed.
METHODS: In a cohort study, we assessed changes in serum levels of glucose, uric acid, cholesterol and triglyceride. We evaluated patients just before commencing modalities of highly active antiretroviral therapy (HAART) that include efavirenz, and every 3 months during the next 2 years. All treatments are among those recommended by current guidelines.
RESULTS: We included 84 patients. Mean ±SD of age is 34.3 ±10.3 years; 60 (71%) were male; 55 (65%) were drug users; 58 (69%) were hepatitis C virus co-infected; 58 (69%) have taken protease inhibitors until the beginning of the study. Baseline CD4 cell count was 323 ±252/mm3, and HIV RNA is 3.9 ±1.5 log10 copies/ml. Serum levels, mean ±SD, at
| baseline | 3 months |
6 months |
9 months |
12 months |
15 months |
18 months |
21 months |
24 months |
||
| Cholesterol: | 186 ±56 | 202 ±61 | 194 ±54 | 193 ±56 | 192 ±55 | 192 ±57 | 195 ±48 | 197 ±57 | 205 ±48 | (P=0.011); |
| uric acid: | 5.4 ±1.8 | 4.9 ±1.6 | 4.9 ±1.5 | 5.0 ±1.6 | 5.0 ±1.5 | 4.9 ±1.5 | 4.7 ±1.5 | 4.9 ±1.5 | 4.9 ±1.7 | (P=0.014); |
| glucose: | 104 ±27 | 105 ±22 | 109 ±18 | 106 ±20 | 107 ±22 | 105 ±19 | 106 ±20 | 108 ±21 | 112 ±26 | (P=0.496); |
| triglyceride: | 229 ±202 | 243 ±282 | 211 ±152 | 236 ±208 | 213 ±153 | 219 ±96 | 246 ±221 | 264 ±252 | 257 ±162 | (P=0.521) |
CONCLUSIONS: HAART with efavirenz causes a mild increase in serum cholesterol, and a mild descent in uric acid, while it has no relevant effect on glucose or triglyceride. Metabolic toxicity of efavirenz seems unimportant.
Presenting author: B Roca
2002-09-22
46
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