Switching to atazanavir improves metabolic disorders in antiretroviral-experienced patients with severe hyperlipidemia.

Abstract

OBJECTIVE:

To describe the efficacy and change in lipid profile in patients with severe hyperlipidemia after switch to an atazanavir-containing highly active antiretroviral therapy regimen.

DESIGN AND METHODS:

Open-field, 24-week, prospective observational cohort study including 33 HIV-infected, antiretroviral-experienced patients with hyperlipidemia. Changes in lipid profiles were evaluated by analyses of triglycerides, total cholesterol, high- and low-density lipoprotein (HDL and LDL) cholesterol, and efficacy by HIV RNA and CD4 cell changes, both from baseline to week 24.

RESULTS:

A rapid and significant decrease of 46% (5.81 +/- 4 mmol/L vs. 3.16 +/- 2.6 mmol/L, P = 0.002) in triglyceride levels was shown. Similarly, a sustained improvement of 18% was observed in total cholesterol levels during the first 24 weeks after switching to atazanavir (6.45 +/- 1.9 mmol/L vs. 5.3 +/- 1.3 mmol/L, P = 0.001). After 24 weeks of treatment there was a significant decrease of 22% in non-HDL cholesterol (5.76 +/- 1.9 mmol/L at baseline vs. 4.5 +/- 1.3 mmol/L at 24 weeks; P = 0.003). HDL and LDL cholesterol profiles did not change significantly as did the viral load or CD4 cell count.

CONCLUSIONS:

Switching to atazanavir results in a significant improvement in HIV therapy-induced hyperlipidemia. A switch to atazanavir is proposed as a valuable option to improve atherogenic lipid profiles while maintaining virologic control.

• Authors: Ulrike Möbius, Margrit Lubach-Ruitman, Brigitte Castro-Frenzel, Matthias Stoll, Stefan Esser, Esther Voigt, Stefan Christensen, Jörg-Andres Rump, Gerd Fätkenheuer, Georg M N Behrens, Reinhold E Schmidt
• Journal: Journal of acquired immune deficiency syndromes (1999) (J Acquir Immune Defic Syndr) Vol. 39 Issue 2 Pg. 174-80 (Jun 01 2005) ISSN: 1525-4135 [Print] United States
• PMID: 15905733 (Publication Type: Clinical Trial, Comparative Study, Controlled Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Oligopeptides
• Pyridines
• Triglycerides
• Atazanavir Sulfate
• Cholesterol

Topics

• Adolescent
• Adult
• Antiretroviral Therapy, Highly Active (adverse effects)
• Atazanavir Sulfate
• Cholesterol (blood)
• Cohort Studies
• Female
• HIV Infections (drug therapy)
• Humans
• Hypercholesterolemia (epidemiology, prevention & control)
• Hyperlipidemias (epidemiology, prevention & control)
• Hypertriglyceridemia (epidemiology, prevention & control)
• Male
• Middle Aged
• Oligopeptides (therapeutic use)
• Pyridines (therapeutic use)
• Triglycerides (blood)