Hyperlipidemia related to the use of HIV-protease inhibitors: natural history and results of treatment with fenofibrate.
Hyperlipidemia has been frequently recorded as a side effect of treating HIV patients with protease inhibitors (PI). This study was initiated to analyze the modifications on blood lipids in HIV-patients receiving PI and the safety and efficacy of the treatment with fenofibrate. Total (TC) and HDL-cholesterol, triglycerides (TG), and CD(4)(+) T-cell counts were measured in 30 HAART-naive patients (Group I) before and after PI introduction. In a second phase of the study, the effects of fenofibrate on lipids, CPK, CD(4)(+), and viral load were determined in 13 patients (Group II) with elevated TC or TG. In Group I, 60% of the patients showed TC or TG elevations. Average increments of 31% and 146% in TC and TG respectively (p<0.0006 and p<0.0001) were observed. In Group II, fenofibrate treatment was associated with decrements of 6.6% (TC) and 45.7% (TG) (p=0.07 and 0.0002) and no modifications on CPK, CD(4)(+), and viral load. In conclusion, hyperlipidemia is common during the treatment of HIV with protease inhibitors, and fenofibrate appears to be an effective and safe choice for its treatment.
Caramelli
B
B
Heart Institute (InCor) and AIDS Clinic, University of São Paulo Medical School, São Paulo, Brazil. bcaramel@usp.br
de Bernoche
C Y
CY
Sartori
A M
AM
Sposito
A C
AC
Santos
R D
RD
Monachini
M C
MC
Strabelli
T
T
Uip
D
D
D000328:Adult; D000368:Aged; D018791:CD4 Lymphocyte Count; D002784:Cholesterol / Q000097:blood; D005260:Female; D011345:Fenofibrate / Q000627:therapeutic use*; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000009:adverse effects*; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D006949:Hyperlipidemias / Q000139:chemically induced / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D014280:Triglycerides / Q000097:blood; D019562:Viral Load
D017320:HIV Protease Inhibitors; D000960:Hypolipidemic Agents; D014280:Triglycerides; D002784:Cholesterol; D011345:Fenofibrate