The effect of switching protease inhibitors to raltegravir on endothelial function, in HIV-infected patients.

Q2 Medicine
Maaike Krikke, Kiki Tesselaar, Guido E L van den Berk, Sigrid A Otto, Laura H Freriks, Steven F L van Lelyveld, Frank J L Visseren, Andy I M Hoepelman, Joop E Arends
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引用次数: 7

Abstract

Objective Lipid management is one of the cornerstones of cardiovascular risk reduction. Treatment of HIV infection with protease inhibitors (PIs) may cause dyslipidaemia, whilst the integrase inhibitor raltegravir (RAL) has a relatively favorable effect on plasma lipids. We examined the effect of switching from PIs to RAL on endothelial function, and its effect on immunological and inflammatory parameters. Methods We performed a 16-week open-label prospective crossover study: 8 weeks intervention (switch PIs to RAL) and 8 weeks control (unchanged cART regimen). Flow-mediated dilatation (FMD), inflammatory plasma, and cellular markers of immune activation were measured at weeks 0, 8, and 16. Results Study participants (n = 22) with a median age of 50 years (IQR 42-60) and known HIV infection of 6.5 years (IQR 5.0-17.3) were on stable cART with undetectable HIV viral loads. After 8 weeks of RAL therapy, a reduction in FMD of -0.81% was seen, compared to +0.54% control (pairwise, p = 0.051), while fasting total cholesterol (-17% versus +10%; p < 0.001), LDL cholesterol (-21% versus -3%; p = 0.026), and triglycerides (-41% versus +18%; p = 0.001) significantly decreased during RAL therapy compared to the control. Furthermore, a relation between the change in percentage of B-1 cells and the change in FMD was found (β 0.40, 95%CI 0.16; 0.64, p = 0.005) during treatment with RAL. Finally, during RAL therapy, 27% of the patients experienced an increased ALT rise. Conclusions We present an overall negative study, where switching from PIs to RAL slightly reduced the endothelial function while decreasing plasma lipids, thus possibly decreasing the CVD risk in the long term. A transient elevation of ALT was seen upon switch to RAL.

在hiv感染患者中将蛋白酶抑制剂转换为雷替格拉韦对内皮功能的影响。
目的控制血脂是降低心血管疾病风险的基础之一。用蛋白酶抑制剂(PIs)治疗HIV感染可能导致血脂异常,而整合酶抑制剂雷替格拉韦(raltegravir, RAL)对血浆脂质有相对有利的作用。我们研究了从pi转换到RAL对内皮功能的影响,以及它对免疫和炎症参数的影响。方法我们进行了一项为期16周的开放标签前瞻性交叉研究:8周干预(将pi转换为RAL)和8周对照(不变的cART方案)。血流介导的扩张(FMD)、炎症血浆和免疫激活的细胞标志物在第0、8和16周进行测量。研究参与者(n = 22)中位年龄为50岁(IQR 42-60),已知HIV感染6.5年(IQR 5.0-17.3),在稳定的cART上检测不到HIV病毒载量。经过8周的RAL治疗后,FMD降低了-0.81%,而对照组为+0.54%(成对,p = 0.051),而空腹总胆固醇(-17% vs +10%;p
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
HIV Clinical Trials
HIV Clinical Trials 医学-传染病学
CiteScore
1.76
自引率
0.00%
发文量
0
审稿时长
>12 weeks
期刊介绍: HIV Clinical Trials is devoted exclusively to presenting information on the latest developments in HIV/AIDS clinical research. This journal enables readers to obtain the most up-to-date, innovative research from around the world.
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