|
9th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV19-21 July 2007, Sydney, Australia |
RACIAL DIFFERENCES IN LONG-TERM CHANGES IN METABOLIC PARAMETERS IN ANTIRETROVIRAL-NAÏVE PERSONS INITIATING HAART
Antiviral Therapy 2007; 12(Suppl. 2):L19 (abstract no. O-24A)
CL Gibert1, JC Shlay2, S Sharma3, G Bartsch3, G Peng3 and C Grunfeld4 for the Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA)
1Wide-Reaching AIDS Program, Veterans Affairs Medical Center and George Washington University, Washington DC, USA; 2Denver Community Programs for Clinical Research on AIDS, University of Colorado Health Sciences Center, Denver, CO, USA; 3CPCRA
Statistical and Data Management Center, University of Minnesota, Minneapolis, MN, USA; 4Veterans Affairs Medical Center and University of California, San Francisco, CA, USA
OBJECTIVES: To compare by race long-term changes in metabolic parameters in persons initiating HAART.
METHODS: We studied 400 participants. Fasting metabolic parameters were measured at baseline, month 1, 4 and 4month intervals. Mean changes and rates of change (slopes) were compared with a median follow-up of 60 months. Insulin resistance (IR) was determined using HOMA.
RESULTS: Mean age was 38 years, 22% female, 11% Latino, 61% African-American (AA), 28% Caucasian (W). ART usage was similar except nelfinavir use was greater in Latinos. Mean changes from baseline and differences in mean change with P-values by race are provided in Table 1. AAs had the smallest increase in lipids. Latinos and Ws had significantly greater increases in triglycerides (TG) and LDL cholesterol than AAs. Glucose and IR increased significantly for Latinos and AAs. Glucose increase was greater in Latinos than AAs and Ws. Increase in IR was greater in Latinos than Ws. Rates of change given in Table 2. Slopes were positive for TG, glucose and IR, and negative for LDL due to early increases followed by decreases. Latinos had greater slopes for TG (versus AAs), glucose (versus AAs and Ws) and IR (versus AAs and Ws) (data not shown).
|
|
||||||
| Table 1. (Abstract O-24A) | ||||||
|
|
||||||
| Mean change from baseline (P-value) | Difference in mean change (P-value) | |||||
|
|
|
|||||
| Outcome measures | Latino (n=43) | AA (n=239) | W (n=112) | Latino-AA | Latino-W | W-AA |
|
|
||||||
| TG, mg/dl | 49.15 (<0.01) | 13.56 (<0.01) | 38.15 (<0.01) | 37.1 (<0.01) | 4.97 (0.72) | 32.2 (<0.01) |
| LDL Chol, mg/dl | 16.06 (<0.01) | 5.91 (<0.01) | 15.35 (<0.01) | 8.63 (0.02) | –1.25 (0.76) | 9.88 (<0.01) |
| Glucose, mg/dl | 11.34 (<0.01) | 5.29 (<0.01) | 1.93 (0.22) | 6.01 (<0.01) | 6.28 (<0.01) | –0.27 (0.85) |
| IR | 1.32 (<0.01) | 1.08 (<0.01) | 0.43 (0.09) | 0.34 (0.45) | 1.12 (0.01) | –0.43 (0.13) |
|
|
||||||
|
|
||||||||
| Table 2. (Abstract 0-24A) | ||||||||
|
|
||||||||
| TG, mg/dl/month | LDL-chol, mg/dl/month | Glucose, mg/dl/month | IR | |||||
|
|
|
|
|
|||||
| Race | Slope | P-value | Slope | P-value | Slope | P-slope | Slope | P-value |
|
|
||||||||
| Latino | 1.11 | <0.01 | -0.43 | <0.01 | 0.28 | <0.01 | 0.06 | <0.01 |
| AA | 0.15 | 0.30 | -0.35 | <0.01 | 0.04 | 0.04 | 0.02 | <0.01 |
| W | 0.42 | 0.05 | -0.23 | <0.01 | 0.02 | 0.53 | 0.02 | <0.01 |
|
|
||||||||
CONCLUSIONS: In this prospective non-randomized evaluation, changes in metabolic parameters differed by race with Latinos having more adverse changes. Changes in metabolic parameters following initiation of HAART differ by race in addition to recognized differences by specific ART.
Download PDF of this abstract.
2007-07-24
O-24A
Copyright © 2007 - International Medical Press Ltd. Reproduction of this abstract (other than one copy for personal reference) must be cleared through the Medical Editor, International Medical Press, 36 St Mary-at-Hill, London EC3R 8DU, United Kingdom.