title: Dyslipidaemia in HIV-1-infected patients receiving protease inhibitors after initial treatment with first-line-based non-nucleoside reverse transcriptase inhibitors: a cross-sectional study.
abstract: OBJECTIVE
  Lipid abnormalities associated with antiretroviral therapy in people with HIV infection are more frequent with protease inhibitors (PI)-based regimens. Whether effects extend to patients receiving a PI subsequent to failure on non-nucleoside reverse-transcriptase inhibitors (NNRTI)-based regimen is still unknown. We investigated the effects of secondary treatment with a PI on the lipid profile in a group of patients with HIV infection in Cameroon.
  
  
  METHODS
  This was a cross-sectional study.
  
  
  METHODS
  This study was carried out at the registered centre for HIV treatment of the Yaounde Jamot Hospital in Cameroon.
  
  
  METHODS
  Participants were consecutively recruited between November 2009 and January 2010. There were 138 HIV-1 patients on initial treatment with an NNRTI regimen and 66 HIV patients on secondary treatment with a PI for at least 12 months. Lipid abnormalities were based on the National Cholesterol Education Program, Adult Treatment Panel III criteria.
  
  
  METHODS
  Levels of lipid parameters among patients on PI and NNRTI.
  
  
  RESULTS
  Median (IQR) levels (mg/dl), NNRTI-treated versus PI-treated patients were 185 (149-225) and 189 (147-244) for total cholesterol, 46 (27-66) and 42 (28-82) for high-density lipoprotein (HDL)-cholesterol, 121 (90-169) and 126.9 (71-176) for low-density lipoprotein (LDL)-cholesterol, 134 (98-174) and 138 (111-167) for triglycerides, and 4.3 (2.9-6.2) and 5.1 (2.6-7.9) for total/HDL-cholesterol ratio (all p>0.32). The most frequent lipid abnormality in the two groups was high LDL-cholesterol (46.4% (NNRTI) vs 54.5% (PI)). The occurrence of lipid abnormalities was similar in the two groups (all p>0.29).
  
  
  CONCLUSIONS
  The use of PI does not appear to deteriorate the lipid profile of HIV patients above and beyond abnormalities induced by an unsuccessful initial treatment with NNRTI. Monitoring of lipid profile during HIV treatment regardless of the regimens would improve timely detection and management of abnormalities, to mitigate related risks.
authors.affiliation: Department of Internal Medicine and Subspecialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon.
authors.forename: Eric Walter
authors.initials: EW
authors.lastname: Pefura Yone
authors.forename: André Pascal
authors.initials: AP
authors.lastname: Kengne
authors.forename: Gloria
authors.initials: G
authors.lastname: Ashuntantang
authors.forename: Awa Foueudjeu
authors.initials: AF
authors.lastname: Betyoumin
authors.forename: Jeanne
authors.initials: J
authors.lastname: Ngogang