Sixth International Congress

Drug Therapy in HIV Infection


17-21 November, 2002
Glasgow, UK

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Lipid profiles on therapy with PI. The D:A:D (data collection on adverse events of anti-HIV drugs) study.

C Pradier, E Fontas1, C Sabin2, N Friis-Møller, JD Lundgren for the D:A:D study group3, R Weber4, P Reiss5, A d’Arminio Monforte6, O Kirk7, R Thiebaut8, L Morfeldt9, G Calvo10, M Law11, G Bartsch12, S De Wit13
Int Cong Drug Therapy HIV 2002 Nov 17-21;6:Abstract No. PL12.1

To compare the impact of the various individual PIs and PI combinations on dyslipidaemia.

Baseline risk factors for the development of cardiovascular disease (CVD) were collected on 17,852 HIV-patients from Europe, USA and Australia, enrolled in DAD, a prospective cohort study assessing risk of CVD, established in year 2000. Dyslipidemia was assessed among patients currently receiving a PI-containing regimen at enrolment. Dyslipidaemia was defined as elevated total cholesterol (TC) =6.2 mmol/L, decreased HDL-cholesterol = 0.9 mmol/L, elevated TC/HDL-c ratio =6.5, or elevated triglycerides (TG) =2.3 mmol/L.

Among the 7,729 patients currently receiving a PI-containing regimen (79% male), 72 were receiving amprenavir (amp), 2,354 indinavir (ind), 2,574 nelfinavir (nel), 576 saquinavir (saq), 515 ritonavir (rtv), 1464 a double PI regimen including rtv and 174 a double PI regimen excluding rtv. The proportions with elevated TC were 24%, 23%, 25%, 16%, 37%, 37%, 25% respectively (p<0.001); decreased HDL-c : 42%, 32%, 20%, 30%, 30%, 30%, 29% (p<0.001); elevated TC/HDL-c ratio : 26%, 23%, 16%, 14%, 30%, 31%, 22% (p<0.001); elevated TG : 52%, 34%, 33%, 28%, 62%, 57%, 47% (p<0.001). In a multivariate logistic regression model adjusted for cardiovascular risks and HIV factors, the odds ratios for dyslipidaemia were: see table below.

Main other factors which remained significantly associated with elevated TC/HDL-c ratio were: male gender, previous AIDS defining illness, higher CD4 T-cells; with elevated TG: male gender, previous AIDS, higher CD4 T-cells and cumulative PI exposure.

Rtv based regimens were associated with an increased risk for elevated TC/HDL-c ratio and elevated TG, while nel was associated with a reduced risk of low-level HDL-c and saq with a reduced risk of elevated TC/HDL ratio. Double PI combinations excluding rtv do not appear to be associated with higher risk of dyslipidaemia than non-rtv single PI regimens.

  TC ≥6.2 HDL-c ≤0.9 TC/HDL-c ≥6.5 TG ≥2.3
  OR p-value OR p-value OR p-value OR p-value
Ind 1 - 1 - 1 - 1 -
Nel 1.28 0.009 0.61 0.0001 0.80 0.70 1.05 0.56
Rtv 1.98 0.0001 0.98 0.92 1.48 0.04 3.22 0.0001
Saq 0.75 0.10 0.85 0.47 0.51 0.02 0.90 0.47
2PI inc Rtv 2.13 0.0001 0.79 0.09 1.42 0.02 1.95 0.0001
2PI exc Rtv 1.21 0.44 0.75 0.37 0.83 0.60 1.18 0.43
Amp 1.26 0.53 0.96 0.92 0.87 0.78 1.36 0.32

Presenting author: C Pradier

Download Conferences Abstracts

1 Nice Cohort, France.

2 Royal Free, United Kingdom.

3 DAD Coord Centre, Denmark.

4 SHCS, Switzerland.

5 ATHENA, Netherlands.

6 ICONA, Italy.

7 EuroSIDA, Denmark.

8 Aquitaine, France.

9 HIVBivus, Sweden.

10 BASS, Spain.

11 AHOD, Australia.

12 CPCRA, USA.

13 Brussels HIV Cohort, Belgium.

2002-11-17
PL12-1

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