Lipid disorders in antiretroviral-naive patients treated with lopinavir/ritonavir-based HAART: frequency, characterization and risk factors.
OBJECTIVE
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.
Montes
Maria Luisa
ML
Internal Medicine Service, La Paz Hospital, Autónoma University School of Medicine, Madrid, Spain.
Pulido
Federico
F
Barros
Carlos
C
Condes
Emilia
E
Rubio
Rafael
R
Cepeda
Concepción
C
Dronda
Fernando
F
Antela
Antonio
A
Sanz
José
J
Navas
Enrique
E
Miralles
Pilar
P
Berenguer
Juan
J
Pérez
Susana
S
Zapata
Angeles
A
González-García
Juan J
JJ
Peña
Jose Ma
JM
Vázquez
J J
JJ
Arribas
Jose R
JR
D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D006937:Hypercholesterolemia / Q000139:chemically induced; D006949:Hyperlipidemias / Q000139:chemically induced*; D015228:Hypertriglyceridemia / Q000139:chemically induced; D008055:Lipids / Q000097:blood; D061466:Lopinavir; D008297:Male; D008875:Middle Aged; D011744:Pyrimidinones / Q000009:adverse effects* / Q000627:therapeutic use; D012307:Risk Factors; D019438:Ritonavir / Q000009:adverse effects* / Q000627:therapeutic use; D014280:Triglycerides / Q000097:blood
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D017320:HIV Protease Inhibitors; D008055:Lipids; D011744:Pyrimidinones; D014280:Triglycerides; D061466:Lopinavir; D019438:Ritonavir