Improvement of lipid profiles when switching from efavirenz to rilpivirine in HIV-infected patients with dyslipidemia

Q2 Medicine
Pornpimol Thamrongwonglert, P. Chetchotisakd, S. Anunnatsiri, P. Mootsikapun
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引用次数: 23

Abstract

Rilpivirine (RPV) is a non-nucleoside reverse transcriptase inhibitor, which has better lipid profiles than efavirenz (EFV) in treatment naïve patients. However, the data on treatment experience are limited especially in dyslipidemic HIV patients; thus, we aimed to assess the change of lipid profiles after switching from EFV to RPV in these patients. In this prospective, open-label, cohort study, we enrolled HIV-1 infected adults who had received at least 6 months of EFV-based regimen, with HIV RNA <50 copies/mL for ≥6 months prior to switching. The objectives of this study were to analyze lipid changes and to evaluate the efficacy, safety, tolerability at 24 weeks after switching therapy. Fifty-three patients were enrolled and completed the study. At week 24, a significant decrease in the mean (95% confident interval, CI) total cholesterol (−28.06 mg/dL, 95%CI −35.20 to −20.91, p < 0.0001), LDL-cholesterol (−20.96 mg/dL, 95%CI −28.12 to −13.80, p < 0.0001), high-density lipoprotein (HDL)-cholesterol (−5.11 mg/dL, 95%CI −7.79 to −2.44, p < 0.0001), and triglyceride (−29.79 mg/dL. 95%CI −52.39 to −7.19, p = 0.011) levels were observed. One patient had virologic rebound with HIV RNA of 114 copies/mL at week 24. Three (5.7%) patients had grade 2 elevations of liver enzymes. None of the patients discontinued RPV during the study. Switching from EFV-based therapy to RPV-based regimen improved lipid profiles in fully suppressed HIV patients with dyslipidemia. This treatment should be considered in these patients.
在患有血脂异常的hiv感染患者中,从依非韦伦切换到利匹韦林时脂质谱的改善
Rilpivirine (RPV)是一种非核苷类逆转录酶抑制剂,在治疗naïve患者时比efavirenz (EFV)具有更好的脂质谱。然而,关于治疗经验的数据有限,特别是在血脂异常的HIV患者中;因此,我们的目的是评估这些患者从EFV转为RPV后脂质谱的变化。在这项前瞻性、开放标签、队列研究中,我们招募了接受至少6个月基于efv的方案的HIV-1感染成人,在转换方案前HIV RNA <50拷贝/mL≥6个月。本研究的目的是分析脂质变化,并评估转换治疗后24周的疗效、安全性和耐受性。53名患者入组并完成了研究。在第24周,平均(95%可信区间,CI)总胆固醇(- 28.06 mg/dL, 95%CI - 35.20至- 20.91,p < 0.0001)、低密度脂蛋白胆固醇(- 20.96 mg/dL, 95%CI - 28.12至- 13.80,p < 0.0001)、高密度脂蛋白胆固醇(- 5.11 mg/dL, 95%CI - 7.79至- 2.44,p < 0.0001)和甘油三酯(- 29.79 mg/dL)显著下降。95%CI为- 52.39 ~ - 7.19,p = 0.011)。1例患者在第24周出现病毒学反弹,HIV RNA为114拷贝/mL。3例(5.7%)患者肝酶升高2级。在研究期间没有患者停止RPV。从以efv为基础的治疗转向以rpv为基础的方案改善了完全抑制的患有血脂异常的HIV患者的脂质谱。在这些患者中应该考虑这种治疗。
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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