Abstract | BACKGROUND: Metabolic effects following combination antiretroviral therapy (cART) vary by regimen type. Changes in metabolic effects were assessed following cART in the AIDS Clinical Trials Group (ACTG) A5257 study, and correlated with plasma ritonavir trough concentrations (C24). METHODS: Treatment-naive adult subjects were randomized to ritonavir-boosted atazanavir or darunavir, or raltegravir-based cART. Changes in lipids and other metabolic outcomes over time were estimated. Differences between arms were estimated with 97.5% confidence intervals and compared using pairwise Student t tests. Associations between ritonavir C24 and lipid changes at week 48 were evaluated via linear regression. RESULTS: CONCLUSIONS:
Raltegravir produced the most favorable lipid profile. Metabolic syndrome rates were high at baseline and increased to the same degree in all arms. Ritonavir C24 was not different in the PI arms and had no relationship with the modest but comparable increases in lipids observed with either atazanavir or darunavir. The long-term clinical significance of the lipid changes noted with the PIs relative to raltegravir deserves further evaluation. CLINICAL TRIALS REGISTRATION: NCT 00811954.
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Authors | Ighovwerha Ofotokun, Lumine H Na, Raphael J Landovitz, Heather J Ribaudo, Grace A McComsey, Catherine Godfrey, Francesca Aweeka, Susan E Cohn, Manish Sagar, Daniel R Kuritzkes, Todd T Brown, Kristine B Patterson, Michael F Para, Randi Y Leavitt, Angelina Villasis-Keever, Bryan P Baugh, Jeffrey L Lennox, Judith S Currier, AIDS Clinical Trials Group (ACTG) A5257 Team |
Journal | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
(Clin Infect Dis)
Vol. 60
Issue 12
Pg. 1842-51
(06 15 2015)
ISSN: 1537-6591 [Electronic] United States |
PMID | 25767256
(Publication Type: Clinical Trial, Phase III, Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
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Copyright | © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: [email protected]. |
Chemical References |
- Anti-HIV Agents
- Blood Glucose
- Lipids
- Raltegravir Potassium
- Atazanavir Sulfate
- Ritonavir
- Darunavir
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Topics |
- Adult
- Anti-HIV Agents
(administration & dosage, pharmacology, therapeutic use)
- Atazanavir Sulfate
(administration & dosage, pharmacology, therapeutic use)
- Blood Glucose
(drug effects)
- Darunavir
(administration & dosage, pharmacology, therapeutic use)
- Drug Therapy, Combination
- Female
- HIV Infections
(drug therapy, metabolism)
- HIV-1
- Humans
- Lipids
(blood)
- Male
- Raltegravir Potassium
(administration & dosage, pharmacology, therapeutic use)
- Ritonavir
(administration & dosage, pharmacology, therapeutic use)
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