Effects of nevirapine, compared with lamivudine, on lipids and lipoproteins in HIV-1-uninfected newborns: the stopping infection from mother-to-child via breast-feeding in Africa lipid substudy.
BACKGROUND
The objective of the present study was to assess whether the high-density lipoprotein cholesterol (HDL-c)-increasing effect of nevirapine (NVP), as observed in human immunodeficiency virus type 1 (HIV-1)-infected subjects, at least in part may relate to intrinsic properties of NVP.


METHODS
At 2, 6, and 12 weeks after birth, complete lipid profiles as well as plasma apolipoproteins levels were assessed in 80 HIV-uninfected newborns, half of whom received NVP and half lamivudine (3TC), respectively. Newborns were randomly selected from a randomized trial in which NVP or 3TC had been administered to HIV-uninfected infants born to HIV-infected mothers to try and prevent HIV-1 transmission from occurring during breast-feeding.


RESULTS
After 6 weeks of therapy, the expected physiological decline in HDL-c levels in the newborns was attenuated in infants treated with NVP, compared with levels in those treated with 3TC. Apolipoprotein A-I (apoA-I) levels were higher at all time points in the NVP arm than they were in the 3TC arm (P=.02), reaching peak levels at 6 weeks. The difference in HDL-c was no longer significant at 12 weeks.


CONCLUSIONS
apoA-I levels and HDL-c were elevated in HIV-1-uninfected newborns receiving NVP, compared with those receiving 3TC. These data support that NVP may indeed have intrinsic apoA-I and HDL-c elevating properties in humans.
Sankatsing
Raaj R
RR
Department of Vascular Medicine, University of Amsterdam, Amsterdam, The Netherlands. r.r.sankatsing@amc.uva.nl
Wit
Ferdinand W
FW
Pakker
Nadine
N
Vyankandondera
Joseph
J
Mmiro
Francis
F
Okong
Pius
P
Kastelein
John J
JJ
Lange
Joep M
JM
Stroes
Erik S
ES
Reiss
Peter
P
D000328:Adult; D000349:Africa; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001053:Apolipoproteins / Q000097:blood*; D001774:Blood Chemical Analysis; D001942:Breast Feeding; D008076:Cholesterol, HDL / Q000097:blood*; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000517:prevention & control* / Q000635:transmission; D015497:HIV-1 / Q000254:growth & development; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D019259:Lamivudine / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D019829:Nevirapine / Q000009:adverse effects* / Q000627:therapeutic use
D019380:Anti-HIV Agents; D001053:Apolipoproteins; D008076:Cholesterol, HDL; D019259:Lamivudine; D019829:Nevirapine