title: Increase in standard cholesterol and large HDL particle subclasses in antiretroviral-naïve patients prescribed efavirenz compared to atazanavir/ritonavir.
abstract: BACKGROUND
  Cardiovascular risk in HIV-infected patients is related, at least in part, to serum lipid alterations before and after HAART. Lipoprotein-particle subclasses may also have an effect, but comparative data after standard HAART regimens are limited.
  
  
  METHODS
  This was a substudy of a trial in 91 antiretroviral-naïve patients randomized to tenofovir + emtricitabine + atazanavir/ritonavir (ATV/r) or efavirenz (EFV). Over-time trends from baseline to week 48 in total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), HDL particles (HDLp), and TC:HDL-C and TG:HDL-C ratios were analyzed by analysis of covariance (ANCOVA). Furthermore, confidence intervals for differences between the 2 groups at week 48 were calculated. Indications for lipid-lowering interventions and low HDL-C were also studied.
  
  
  RESULTS
  ANCOVA showed that, with respect to patients receiving ATV/r, those prescribed efavirenz (EFV) had greater increases reported as mean differences in lipid values at week 48: 14 mg/dL (95% CI, 0.2 to 27) for TC, 14 mg/dL (95% CI, 4 to 25) for LDL-C, 5 mg/dL (95% CI, 2 to 9) for HDL-C, and 2.2 mg/dL (95% CI, 0.4 to 4) for large HDLp. Proportions of subjects with indications for lipid-lowering interventions and with HDL-C <40 mg/dL did not differ significantly.
  
  
  CONCLUSIONS
  Patients prescribed EFV had greater increases in TC, LDL-C, and HDL-C. Although no significant differences were detected between the 2 groups for the TC:HDL ratio and for indications to start lipid-lowering interventions, large HDLp increased more in the EFV group compared to the ATV/r group, suggesting a protective effect associated with EFV use.
authors.affiliation: Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy.
authors.forename: Daria
authors.initials: D
authors.lastname: Gotti
authors.forename: Bruno Mario
authors.initials: BM
authors.lastname: Cesana
authors.forename: Laura
authors.initials: L
authors.lastname: Albini
authors.forename: Alessandra
authors.initials: A
authors.lastname: Calabresi
authors.forename: Ilaria
authors.initials: I
authors.lastname: Izzo
authors.forename: Emanuele
authors.initials: E
authors.lastname: Focà
authors.forename: Davide
authors.initials: D
authors.lastname: Motta
authors.forename: Rita
authors.initials: R
authors.lastname: Bellagamba
authors.forename: Rita
authors.initials: R
authors.lastname: Fezza
authors.forename: Pasquale
authors.initials: P
authors.lastname: Narciso
authors.forename: Laura
authors.initials: L
authors.lastname: Sighinolfi
authors.forename: Paolo
authors.initials: P
authors.lastname: Maggi
authors.forename: Nigritella
authors.initials: N
authors.lastname: Brianese
authors.forename: Eugenia
authors.initials: E
authors.lastname: Quiros-Roldan
authors.forename: Giovanni
authors.initials: G
authors.lastname: Guaraldi
authors.forename: Carol
authors.initials: C
authors.lastname: Torti
mesh_terms: D000328:Adult; D000480:Alkynes; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000069446:Atazanavir Sulfate; D048588:Benzoxazines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008076:Cholesterol, HDL / Q000097:blood*; D003521:Cyclopropanes; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011725:Pyridines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D019438:Ritonavir / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D008076:Cholesterol, HDL; D003521:Cyclopropanes; D009842:Oligopeptides; D011725:Pyridines; D000069446:Atazanavir Sulfate; C098320:efavirenz; D019438:Ritonavir