2nd International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV 13-15 September 2000, Toronto, Canada

LIPID PROFILES IN HIV-INFECTED PATIENTS BEFORE AND AFTER PROTEASE INHIBITOR THERAPY

Antiviral Therapy 2000; 5(Suppl. 5):29 (abstract no. P8)

C Wanke, J Gerrior, S Skinner, JR McNamara and EJ Schaefer
Tufts University School of Medicine and Human Nutrition Research Center; Boston, Mass.,USA

BACKGROUND: The use of protease inhibitor (PI) therapy in patients infected with HIV has been linked to alterations in lipid profiles.

OBJECTIVES: To document lipid profiles pre- and post-PI therapy, and to compare them to controls from the Framingham Heart Study offspring cohort (FHS) matched for sex, age and ethnicity.

DESIGN: Longitudinal cohort study.

RESULTS: Pre- and post-PI samples were available from 42 men and seven women; mean age 40.6 years. Mean CD4 count pre-PI was 242 (205 cells/mm³; HIV RNA was 4.2 log₁₀ copies/ml; weight was 75.5±14.6 kg; BMI was 24±3.6 kg/m²; body fat 17.1±9.11 kg (by BIA), intake was 2653±730 calories/day. Post-PI samples were collected 6.9±4.3 months after starting therapy. CD4 counts increased to 384±323 cells/mm³ and RNA decreased by 1 log₁₀ post-PI. Pre-PI total cholesterol (TC) in males was 167.6± 42.4 mg/dl versus FHS males at 202.7±36.4 mg/dl (P<0.0001);TC increased to 190.4±47.9 mg/dl post-PI (P<0.0001). Pre-PI TG were 162.8±104.9 mg/dl versus FHS at 119.6±75.9 mg/dl (P<0.009); TG increased post-PI to 237.2±252.2 mg/dl (P<0.03). LDL C was 97.8±31 mg/dl pre-PI versus FHS at 132.8±33.4 mg/dl (P<0.0001) and rose to 107.b:34.7 mg/dl post-PI (P<0.02). There was no significant change in HDL or Lpa pre- and post-PI; HDL was lower in HIV (35.2±10.0 mg/dl) than in FHS (46.0±9.8 mg/dl; P<0.0001).

CONCLUSIONS: Initiation of PI therapy does significantly and promptly alter lipid profiles in HIV-infected patients. Longitudinal studies are needed to demonstrate whether these alterations contribute to additional cardiovascular risk.

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