Switching to atazanavir improves metabolic disorders in antiretroviral-experienced patients with severe hyperlipidemia.
OBJECTIVE
To describe the efficacy and change in lipid profile in patients with severe hyperlipidemia after switch to an atazanavir-containing highly active antiretroviral therapy regimen.


METHODS
Open-field, 24-week, prospective observational cohort study including 33 HIV-infected, antiretroviral-experienced patients with hyperlipidemia. Changes in lipid profiles were evaluated by analyses of triglycerides, total cholesterol, high- and low-density lipoprotein (HDL and LDL) cholesterol, and efficacy by HIV RNA and CD4 cell changes, both from baseline to week 24.


RESULTS
A rapid and significant decrease of 46% (5.81 +/- 4 mmol/L vs. 3.16 +/- 2.6 mmol/L, P = 0.002) in triglyceride levels was shown. Similarly, a sustained improvement of 18% was observed in total cholesterol levels during the first 24 weeks after switching to atazanavir (6.45 +/- 1.9 mmol/L vs. 5.3 +/- 1.3 mmol/L, P = 0.001). After 24 weeks of treatment there was a significant decrease of 22% in non-HDL cholesterol (5.76 +/- 1.9 mmol/L at baseline vs. 4.5 +/- 1.3 mmol/L at 24 weeks; P = 0.003). HDL and LDL cholesterol profiles did not change significantly as did the viral load or CD4 cell count.


CONCLUSIONS
Switching to atazanavir results in a significant improvement in HIV therapy-induced hyperlipidemia. A switch to atazanavir is proposed as a valuable option to improve atherogenic lipid profiles while maintaining virologic control.
Möbius
Ulrike
U
Department of Clinical Immunology, Hannover Medical School, Hannover, Germany. moebius.ulrike@mh-hannover.de
Lubach-Ruitman
Margrit
M
Castro-Frenzel
Brigitte
B
Stoll
Matthias
M
Esser
Stefan
S
Voigt
Esther
E
Christensen
Stefan
S
Rump
Jörg-Andres
JA
Fätkenheuer
Gerd
G
Behrens
Georg M N
GM
Schmidt
Reinhold E
RE
D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D000069446:Atazanavir Sulfate; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology / Q000517:prevention & control; D006949:Hyperlipidemias / Q000453:epidemiology* / Q000517:prevention & control; D015228:Hypertriglyceridemia / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000627:therapeutic use*; D011725:Pyridines / Q000627:therapeutic use*; D014280:Triglycerides / Q000097:blood
D009842:Oligopeptides; D011725:Pyridines; D014280:Triglycerides; D000069446:Atazanavir Sulfate; D002784:Cholesterol