Rapid progression of carotid lesions in HAART-treated HIV-1 patients.
To obtain data on the evolution of carotid lesions, we evaluated 133 patients at their first antiretroviral regimen, followed for at least 2 years; 77 treated with protease inhibitors (PIs): Group A and 56 with non-nucleosidic reverse transcriptase inhibitors (NNRTIs): Group B. All patients were subjected to carotid ultrasonography. In Group A, among the previously normal patients 22.5% developed lesions, 40% remained normal, 37.5% shifted to other antiretroviral regimens. Among the 37 previously pathologic patients, 46% worsened, 19% were stable, in 8% the lesions had disappeared, 27% shifted. In Group B, among the previously normal patients, 12.7% developed lesions, 80.8% remained unaltered, 6.5% shifted. Among the previously pathologic patients, 12.5% worsened, lesions reversed in 25%, remained stable in 50% and 12.5% shifted to PI. At statistical analysis, in Group A both the percentage of patients developing new lesions and the percentage of patients who worsened was significantly higher. In conclusion, we evidenced a more rapid onset of lesions in patients treated with PIs with respect to patients treated with NNRTIs and towards a more rapid evolution of the previous lesions. The shift from PIs to NNRTI/3 NRTI seems related to a lower rate of evolution. Interestingly, a disappearance of lesions was detected in both groups.
Maggi
Paolo
P
Institute of Infectious Diseases, University of Bari, Italy. p_maggi@yahoo.com <p_maggi@yahoo.com>
Perilli
Francesco
F
Lillo
Antonio
A
Gargiulo
Miriam
M
Ferraro
Sergio
S
Grisorio
Benvenuto
B
Ferrara
Sergio
S
Carito
Valentina
V
Bellacosa
Chiara
C
Pastore
Giuseppe
G
Chirianni
Antonio
A
Regina
Guido
G
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D002340:Carotid Artery Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging; D005260:Female; D017320:HIV Protease Inhibitors / Q000009:adverse effects; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects; D018615:Ultrasonography, Doppler, Color
D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors