Abstract

BackgroundDyslipidemia represents a significant non-infectious comorbidity among people living with HIV. The aim of this study is to evaluate the impact on lipid profile of switches from an efavirenz (EFV) or protease inhibitor/ritonavir (PI/r)-based regimen to a rilpivirine (RPV) or a once-daily integrase inhibitor-based regimen.MethodsWe analyzed data from SCOLTA prospective database. All patients with HIV-RNA < 50 copies/ml in therapy with two NRTI + EFV or PI/r were included if they switched from EFV to dolutegravir (group EFV-DTG), elvitegravir (EFV-EVG), or RPV (EFV-RPV) and from PI/r to DTG (PI/r-DTG), PI/r to EVG (PI/r-EVG), or PI/r to RPV (PI/r-RPV). Total cholesterol (TC), TC/HDL ratio, LDL-cholesterol (LDL) and triglycerides (TG) were compared at baseline, six months and one year. Comparisons among groups were performed by a general linear model.ResultsFour hundred and ninety patients were enrolled, 24.9% female, mean age 47.3 years (±10.1). According to ART switch, 11.4% were classified in group EFV-DTG, 3.9% in EFV-EVG, 23.9% in EFV-RPV, 17.6% in PI/r-DTG, 17.8% in PI/r-EVG, and 25.5% in PI/r-RPV. After adjusted analysis, TC significantly decreased in all groups but EFV-EVG, TC/HDL in all but EFV-DTG and EFV-EVG, while the reduction of TG was significant only in switches to RPV (EFV-RPV and PI/r-RPV). The one year decrease of TC, TC/HDL, LDL and TG was higher in patients with higher baseline levels of the same variable (p < .0001 for all).ConclusionsIn SCOLTA, all switches from PI/r regimens gave advantages on lipid profile, while stopping EFV had consistently favorable lipid effects only if replaced by RPV.

Highlights

  • Dyslipidemia represents a significant non-infectious comorbidity among people living with HIV

  • The aim of this study is to evaluate the impact on lipid profile of a switch from an EFV or protease inhibitor/ ritonavir (PI/r)-based regimen to a RPV or a once-daily Integrase strand transfer inhibitors (INSTIs)-based regimen in a prospective observational cohort of HIV-infected individuals

  • According to the type of antiretroviral therapy (ART) switch, 56 (11.4%) patients were classified as group EFV-DTG, 19 (3.9%) EFV-EVG, 117 (23.9%) EFV-RPV, (17.6%) PI/r-DTG, (17.8%) PI/r-EVG, and 125 (25.5%) PI/r-RPV

Read more

Summary

Introduction

Dyslipidemia represents a significant non-infectious comorbidity among people living with HIV. The aim of this study is to evaluate the impact on lipid profile of switches from an efavirenz (EFV) or protease inhibitor/ ritonavir (PI/r)-based regimen to a rilpivirine (RPV) or a once-daily integrase inhibitor-based regimen. Cardiovascular disease represents a significant non-infectious comorbidity among people living with HIV in the era of modern antiretroviral therapy (ART) [1]. Favorable effects on lipid profile are expected in patients switching to a lipid-friendly, once-daily currently available regimen. The aim of this study is to evaluate the impact on lipid profile of a switch from an EFV or PI/r-based regimen to a RPV or a once-daily INSTI-based regimen in a prospective observational cohort of HIV-infected individuals

Objectives
Methods
Results
Discussion
Conclusion
Full Text
Paper version not known

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.