F8/4 - EARLY IMPROVE OF LIPID DISTURBANCES IN HIV INFECTED PATIENTS WITH SUPPRESSED VIRAL LOAD WHO SIMPLIFIED THEIR FIRST PI-CONTAINING TREATMENT TO 3 NRTIS OR 2 NRTIS PLUS NEVIRAPINE

9^TH EUROPEAN AIDS CONFERENCE (EACS)
1^st EACS RESISTANCE & PHARMACOLOGY WORKSHOP

October 25 - 29, 2003 Warsaw, Poland

9.2 Disturbances in Lipid and Glucose Metabolism

F8/4 - EARLY IMPROVE OF LIPID DISTURBANCES IN HIV INFECTED PATIENTS WITH SUPPRESSED VIRAL LOAD WHO SIMPLIFIED THEIR FIRST PI-CONTAINING TREATMENT TO 3 NRTIS OR 2 NRTIS PLUS NEVIRAPINE

* Bonjoch A.¹, Gel S.¹, Galvez J.², Miralles C.³, de la Torre J.⁴, Prieto A.⁵, Viladés C.⁶, Márquez M.⁷, Mariño A.⁸, Miranda J.¹, Peña D.⁹, Masabeu A.¹⁰, Pasquau J.¹¹, Rubio M.¹², Terron J.A. (13), Lopez M.J. (14), Knobel H. (15), Clotet B.¹

(1) 'Lluita contra la SIDA' Found HUGTi Pujol, Barcelona,² Hosp de la Macarena, Sevilla,³ Hosp Xeral de Vigo,⁴ Hosp Costa del Sol, Marbella,⁵ Hosp Clínico, Santiago,⁶ Hosp Juan XXIII, Tarragona,⁷ Hosp. Universitario, Málaga,⁸ Hosp Arquitecto Marcide, El Ferrol,⁹ Hosp de la Linea de la Concepción,¹⁰ Hosp de Palamos,¹¹ Hosp de la Nieves, Granada,¹² Hosp Universitari Arnau, Lleida, (13) Hosp de Jerez, (14) Hosp Xeral, Lugo, (15) Hosp del Mar, Barcelona, Spain

Background of Study: One of PI-associated adverse effects is abnormalities in lipid profile. New strategies to reduce lipid toxicities should be assessed.

Objectives: To analyzed lipid changes in pts with supressed viral load for more than 6 months who simplified their first HAART PI-containing.

Methods: prospective open-label randomized study in HIV-infected pts from 17 tertiary Spanish hospitals. Pts were randomized to: Trizivir® (AZT+ABC+3TC),Group1(G1) or Combivir® (AZT+3TC) plus nevirapine, Group2 (G2).HIV RNA, CD4 cells count, lipid profile (total cholesterol (C), triglycerides (TG) and HDL, LDL fractions) were determined at baseline (bl) and each 12 weeks (w).

Results: Sixty-eight pts in G1 and 66 in G2 were recruited. At 12 wks of follow up, hypercholesterolemia decreased from 18% to 2% in G1 (p= 0.004) and from 18% to 4% in G2 (p=0.02) This improvement was maintained at w36. LDL-C decreased in G1 (mean, mmol/L, ±SD) from 3.60 (± 1.13) to 2.87 (± 0.89) (p=0.003) at w12, to 2.71 (±0.92) (p=0.0009)at w24 and 2.90 (±0.84) (p=0.02) at w36; In G2, LDL improved from 3.54 (± 0.95) at bl to 3.12 (± 0.94) at w12, (p=0.05);at w24: 3.32 (±1.12) (p=ns) and 2.89(± 0.99) (p=0.01) at w36. HDL-C remained stable in both arms. TG decreased a mean of 0.45 mmol/L in G1(from 2.19 to 1.78) and 0.56 in G2 (from 2.4 to 1.85) (p=ns). No significant differences in lipid profile had been found between groups. Both arms maintained immunological reconstitution and virological efficacy.

Conclusions: Both simplified therapies improved lipid abnormalities specially in TC and LDL-C in patients from their first HAART PI containing.

Presenting Author: Ph D ANNA BONJOCH, PHYSICIAN, CRTA CANYET, 08916, BADALONA, Spain, Phone: +34 93 497 88 87

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