Background: 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. Methods: We 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. Results: Four 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). Conclusions: In 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.

Taramasso, L., Tatarelli, P., Ricci, E., Madeddu, G., Menzaghi, B., Squillace, N., et al. (2018). Improvement of lipid profile after switching from efavirenz or ritonavir-boosted protease inhibitors to rilpivirine or once-daily integrase inhibitors: Results from a large observational cohort study (SCOLTA). BMC INFECTIOUS DISEASES, 18(1) [10.1186/s12879-018-3268-5].

Improvement of lipid profile after switching from efavirenz or ritonavir-boosted protease inhibitors to rilpivirine or once-daily integrase inhibitors: Results from a large observational cohort study (SCOLTA)

Squillace N.;Bonfanti P.;
2018

Abstract

Background: 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. Methods: We 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. Results: Four 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). Conclusions: In 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.
No
Articolo in rivista - Articolo scientifico
Scientifica
Cholesterol; Dyslipidemia; Framingham risk score; Integrase inhibitors; Rilpivirine;
Cholesterol; Dyslipidemia; Framingham risk score; Integrase inhibitors; Rilpivirine; Adult; Anti-HIV Agents; Benzoxazines; Cohort Studies; Drug Administration Schedule; Drug Therapy, Combination; Female; HIV Infections; HIV-Associated Lipodystrophy Syndrome; Heterocyclic Compounds, 3-Ring; Humans; Integrase Inhibitors; Lipid Metabolism; Lipids; Male; Middle Aged; Protease Inhibitors; Rilpivirine; Ritonavir; Treatment Outcome; Drug Substitution
English
Taramasso, L., Tatarelli, P., Ricci, E., Madeddu, G., Menzaghi, B., Squillace, N., et al. (2018). Improvement of lipid profile after switching from efavirenz or ritonavir-boosted protease inhibitors to rilpivirine or once-daily integrase inhibitors: Results from a large observational cohort study (SCOLTA). BMC INFECTIOUS DISEASES, 18(1) [10.1186/s12879-018-3268-5].
Taramasso, L; Tatarelli, P; Ricci, E; Madeddu, G; Menzaghi, B; Squillace, N; De Socio, G; Martinelli, C; Gulminetti, R; Maggi, P; Orofino, G; Vichi, F; Di Biagio, A; Bonfanti, P; Bellacosa, C; Calza, L; Abeli, C; Celesia, B; Grosso, C; Stagno, A; Mazzotta, F; Penco, G; Cassola, G; Nicolini, L; Dentone, C; Molteni, C; Palvarini, L; Scalzini, A; Carenzi, L; Rizzardini, G; Valsecchi, L; Cordier, L; Rusconi, S; Colombo, V; Galli, M; Franzetti, M; Sgrelli, A; Mazzotta, E; Parruti, G; Bagella, P; Mura, M; Libertone, R; Antinori, A; Di Giambenedetto, S; Guastavigna, M; Caramello, P
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10281/276417
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