Abstract
Antiretroviral therapy in HIV patients is known for its negative effect on the cardiovascular system. One of the major adverse events in patients on lopinavir is increasing lipids. Hyperlipidaemia together with chronic inflammation by HIV-infection itself makes these patients prone for cardiovascular diseases.The purpose of this study (a sub study within the FREE-study) was to determine if higher plasma lopinavir (LPV) concentrations lead to increase of serum lipids. Plasma drug concentrations were analysed up to week 24 in a prospective cohort of HIV antiretroviral therapy naive patients who started on a regimen of zidovudine, lamivudine and ritonavir-boosted lopinavir (FREE study). Prospectively we measured plasma lopinavir concentrations from baseline to week 24 in 72 naive HIV-patients starting on lopinavir (59 males and 13 females). A total of 210 samples were analysed, with at least 2 samples in every patient. Mean LPV trough concentration was 4.3 mg/L (± 2.1). The median intra-subject variation in LPV level was 38% (range 4% - 111%). Serum lipids were not correlated to LPV plasma concentrations possibly due to the wide intra-individual variability in LPV trough levels. Monitoring of plasma lopinavir and subsequent dose adjustment of LPV will not be useful to prevent hyperlipidaemia in HIV-patients treated with lopinavir.
Highlights
The high incidence of the metabolic syndrome is an increasing clinical problem in human immunodeficiency virus (HIV)-patients on antiretroviral therapy (ART) containing protease inhibitors (PIs)
Hyperlipidaemia together with chronic inflammation by HIV-infection itself makes these patients prone for cardiovascular diseases.The purpose of this study was to determine if higher plasma lopinavir (LPV) concentrations lead to increase of serum lipids
Plasma drug concentrations were analysed up to week 24 in a prospective cohort of HIV antiretroviral therapy naive patients who started on a regimen of zidovudine, lamivudine and ritonavir-boosted lopinavir (FREE study)
Summary
The high incidence of the metabolic syndrome is an increasing clinical problem in human immunodeficiency virus (HIV)-patients on antiretroviral therapy (ART) containing protease inhibitors (PIs). Patients with initially high lipid levels are at higher risk of developing (severe) hyperlipidaemia. Lopinavir Plasma Concentrations and Serum Lipids in Therapy Naïve HIV-Patients:. The FREE-study (ClinicalTrials.gov NCT00405925) is a prospective multicenter cohort of HIV-patients starting with ART. In this study therapy-naive patients started on zidovudine (ZDV), lamivudine (3TC) and ritonavir (RTV) boosted lopinavir to achieve an undetectable viral load in short term. Patients with an undetectable viral load between week 12 and 24, were randomised to either continuation of the initial therapy or switch to 3 NRTIs (Trizivir® b.i.d.: each tablet contains 300 mg zidovudine, 150 mg lamivudine and 300 mg abacavir) in order to simplify treatment, facilitate drug adherence and prevent potential long term PI-toxicity. Within the FREE study we investigated whether serum lipid elevation was correlated to LPV exposure
Sign-in/Register to view highlights & summary 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 callDisclaimer: 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.
