Lipid disorders in antiretroviral-naive patients treated with lopinavir/ritonavir-based HAART: frequency, characterization and risk factors

J Antimicrob Chemother. 2005 May;55(5):800-4. doi: 10.1093/jac/dki063. Epub 2005 Mar 10.

Abstract

Objectives: The aim of this study was to evaluate the frequency, characteristics and risk factors of lipid changes associated with lopinavir/ritonavir treatment in antiretroviral-naive patients.

Methods: A prospective cohort of 107 antiretroviral-naive HIV-infected patients was followed for 12 months after starting lopinavir/ritonavir-based highly active antiretroviral therapy.

Results: At 12 months, percentages of patients with hypercholesterolaemia and hypertriglyceridaemia were 17.4% and 40%, respectively. Mean increases in total cholesterol and triglycerides were 40.7 and 73.3 mg/dL. There was a significant increase in both low-density and high-density (HDL) cholesterol, and no increase in the total cholesterol/HDL ratio (from 4.16 at baseline to 4.49 after 12 months). Baseline cholesterol > 200 mg/dL and triglycerides > 150 mg/dL were independent risk factors for dyslipidaemia, while hepatitis C coinfection appeared to be protective.

Conclusions: Patients with elevated lipid values at baseline have the greatest risk of developing hypercholesterolaemia and hypertriglyceridaemia after starting lopinavir/ritonavir. Antiretroviral-naive patients coinfected with hepatitis C have a low risk of developing hyperlipidaemia after starting lopinavir/ritonavir.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antiretroviral Therapy, Highly Active*
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Female
  • HIV Infections / complications
  • HIV Infections / drug therapy*
  • HIV Protease Inhibitors / adverse effects*
  • HIV Protease Inhibitors / therapeutic use
  • Hepatitis C / complications
  • Humans
  • Hypercholesterolemia / chemically induced
  • Hyperlipidemias / chemically induced*
  • Hypertriglyceridemia / chemically induced
  • Lipids / blood
  • Lopinavir
  • Male
  • Middle Aged
  • Pyrimidinones / adverse effects*
  • Pyrimidinones / therapeutic use
  • Risk Factors
  • Ritonavir / adverse effects*
  • Ritonavir / therapeutic use
  • Triglycerides / blood

Substances

  • Cholesterol, HDL
  • Cholesterol, LDL
  • HIV Protease Inhibitors
  • Lipids
  • Pyrimidinones
  • Triglycerides
  • Lopinavir
  • Ritonavir