Plasma lipid profile in pregnant women with HIV receiving nevirapine.
Limited information is currently available on the metabolic profile of nevirapine in pregnancy. We used data from a national observational study to evaluate plasma lipid profile in pregnant women receiving nevirapine. Lipid values were collected during routine clinical visits. Midpregnancy (second trimester) lipid values were analyzed according to use of nevirapine, calculating differences and 95% confidence intervals (CI) between women taking and not taking this drug. In order to adjust for possible confounders, multivariable models were constructed using as dependent variables levels of total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), triglyceride (TG) levels and TC/HDL-C ratio, and as independent variables age, body weight, previous treatment history, CD4 count, and presence of any antiretroviral therapy, use or nonuse of protease inhibitors, stavudine, and nevirapine at the time of blood sampling. Overall, 375 women had available data for analysis. Pregnant women on nevirapine, compared to women not taking this drug, had in univariate analyses higher levels of HDL-C (difference: +13.0mg/dL [95%CI 7.4-18.6], p < 0.001), lower values of TC/HDL-C ratio (difference: -0.51 [0.23-0.80], p < 0.001) and a trend for lower levels of triglycerides (difference: -17.6mg/dL [0.7-35.9], p = 0.06). Higher HDL-C levels were also associated with use of protease inhibitors and with no previous antiretroviral experience before pregnancy. The associations with higher HDL-C levels were confirmed in multivariable analyses. Our study indicates in pregnant women an association between nevirapine use and higher HDL-C levels. Further studies should assess whether this effect is due to an intrinsic activity of nevirapine and define the potential mechanisms involved.
Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanita, Viale Regina Elena 299, 00161 Rome, Italy. marco.floridia@iss.it
Marco
M
Floridia
Enrica
E
Tamburrini
Gianfranco
G
Anzidei
Cecilia
C
Tibaldi
Giovanni
G
Guaraldi
Brunella
B
Guerra
Alessandra Meloni
AM
Meloni
Antonella
A
Vimercati
Atim
A
Molinari
Carmela
C
Pinnetti
Serena
S
Dalzero
Marina
M
Ravizza
D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D002784:Cholesterol / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D039682:HIV-Associated Lipodystrophy Syndrome / Q000188:drug therapy; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy; D008055:Lipids / Q000097:blood*; D019829:Nevirapine / Q000627:therapeutic use*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
D019380:Anti-HIV Agents; D008055:Lipids; D018894:Reverse Transcriptase Inhibitors; D014280:Triglycerides; D002784:Cholesterol; D019829:Nevirapine