Eighth International Congress on Drug Therapy in HIV Infection Glasgow, UK - 12-16 November 2006

Int Cong Drug Therapy HIV 2006 Nov 12-16;8:Abstract No. PL12.2

M vd Valk, N Friis-Møller, C Sabin, F Dabis, A D'Arminio Monforte, R Weber, S Worm, W El-Sadr, S de Wit, C Pradier, O Kirk, M Law, A Philips, J Lundgren, P Reiss
Academic Medical Center, Amsterdam, Netherlands; Royal Free Hospital and Copenhagen HIV Program for the D:A:D Study Group, Copenhagen, Denmark

PURPOSE OF THE STUDY: The use of lipid lowering therapy (LLT) and/or switching ART is recommended in patients on ART with dyslipidaemia. We compared the impact of these two strategies in the D:A:D Study.

METHODS: Patients had received PIs>6 months, were NNRTI-naïve and had confirmed total cholesterol (TC)>6 mmol/l. 3 groups were identified: 1) those starting LLT, 2) those switching PIs to NNRTIs (SWITCH) and 3) a control group (CONTROL) who made no changes to ART. Patients were excluded if ART was changed or LLT started in the next year. Changes in TC, HDL, LDL, TC/HDL and triglyceride (TG) levels over 1 year were compared with multivariable linear regression.

SUMMARY OF RESULTS: Crude lipid changes were significantly different between the three groups (Table). These differences remained after adjustment for baseline characteristics (sex, age, HIV RNA and CD4, smoking, history of CVD, use of CVD drugs, diabetes, previous PI exposure, ethnicity).

CONCLUSIONS: At 1 year, reductions in TC, LDL, TG and TC/HDL were significant for both the LLT and SWITCH groups, whereas a significant HDL rise was only seen in those switching. The effect of the interventions on TC/HDL ratio was similar. Changes were also observed in controls, suggesting some regression to the mean effect, or possible selection of those in whom intervention was withheld in view of declining lipid values.

Plenary Session: Adverse Events II

2006-11-12
PL12.2

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