Lipoprotein Changes in HIV-Infected Antiretroviral-Naïve Individuals after Starting Antiretroviral Therapy: ACTG Study A5152s Stein: Lipoprotein Changes on Antiretroviral Therapy.

TitleLipoprotein Changes in HIV-Infected Antiretroviral-Naïve Individuals after Starting Antiretroviral Therapy: ACTG Study A5152s Stein: Lipoprotein Changes on Antiretroviral Therapy.
Publication TypeJournal Article
Year of Publication2008
AuthorsStein JH, Komarow L, Cotter BR, Currier JS, Dubé MP, Fichtenbaum CJ, Gerschenson M, Mitchell CKC, Murphy RL, Squires K, Parker RA, Torriani FJ
Corporate AuthorsACTG 5152s Study Team
JournalJ Clin Lipidol
Volume2
Issue6
Pagination464-471
Date Published2008 Dec
ISSN1933-2874
Abstract

BACKGROUND: Dyslipidemia is a frequent complication of antiretroviral therapy (ART) for patients with human immunodeficiency virus infection (HIV). The effects of ART on lipoproteins are less well-understood, and have not been investigated in a prospective study where assignment to ART is randomized. OBJECTIVE: To evaluate the effects of three class-sparing ART regimens on lipids and lipoproteins. METHODS: This was a substudy of a prospective, multicenter study treatment-naïve HIV-infected individuals randomly assigned to receive a regimen of nucleoside reverse transcriptase inhibitors (NRTIs) + the non-nucleoside reverse transcriptase inhibitor efavirenz, NRTIs + the protease inhibitor lopinavir/ritonavir, or a NRTI-sparing regimen of efavirenz + lopinavir/ritonavir. Lipoproteins were measured by nuclear magnetic resonance spectroscopy. RESULTS: Among the 82 participants, total and small low-density lipoprotein concentrations increased (median, interquartile range) by 152 (-49 - +407, p<0.01) and 130 (-98 - +417, p<0.01) nmol/L, respectively, especially in the arms containing lopinavir/ritonavir (p(KW)<0.04). Very low-density lipoproteins also increased (p<0.01), with a larger increase in the arms that contained lopinavir/ritonavir (p=0.022). High-density lipoproteins increased by 6.0 nmol/L (2.8 - 10.4, p<0.01), but differences between arms were not significant (p(KW)=0.069). Changes were not related to changes in markers of insulin/glucose metabolism. CONCLUSIONS: Total and small low-density lipoprotein concentrations increased, especially in the arms containing lopinavir/ritonavir, as did increases in total very low-density lipoproteins. Adverse changes were especially prominent in the arm with efavirenz + lopinavir/ritonavir.

DOI10.1016/j.jacl.2008.08.442
Alternate JournalJ Clin Lipidol
PubMed ID19956354
PubMed Central IDPMC2636959
Grant ListK23 RR016176 / RR / NCRR NIH HHS / United States
K23 RR016176-05 / RR / NCRR NIH HHS / United States
K24 AI056933 / AI / NIAID NIH HHS / United States
M01 RR000750 / RR / NCRR NIH HHS / United States
P20 MD000173 / MD / NIMHD NIH HHS / United States
P20 RR016467 / RR / NCRR NIH HHS / United States
R01 HL072711 / HL / NHLBI NIH HHS / United States
U01 AI025859 / AI / NIAID NIH HHS / United States
U01 AI025915 / AI / NIAID NIH HHS / United States
U01 AI034853 / AI / NIAID NIH HHS / United States
U01 AI038855 / AI / NIAID NIH HHS / United States
U01 AI068634 / AI / NIAID NIH HHS / United States
U01 AI068636 / AI / NIAID NIH HHS / United States
U01 AI069424 / AI / NIAID NIH HHS / United States
U01 AI069432 / AI / NIAID NIH HHS / United States
U01 AI069471 / AI / NIAID NIH HHS / United States
U01 AI069513 / AI / NIAID NIH HHS / United States