Changes in lipid levels after 48 weeks of dual versus triple therapy observed in the GARDEL study.
BACKGROUND
Treatment with ritonavir-boosted protease inhibitors and nucleoside analogues frequently leads to rises in lipids, which might increase the cardiovascular risk. The aim of this study was to describe changes in lipid levels among HIV positive patients participating in the GARDEL study.


METHODS
The GARDEL study compared the efficacy and safety of a dual therapy (DT) combination of LPV/r 400/100 mg BID+3TC 150 mg BID to a triple therapy (TT) with LPV/r 400/100 mg BID+3TC or FTC and a third investigator-selected NRTI in fixed-dose combination among HIV+ treatment naïve patients. We compared changes in lipid levels from baseline to week 48 in both arms.


RESULTS
Patient's characteristics were well balanced regarding mean baseline total cholesterol (157 mg/dL DT, 154 mg/dL TT), triglycerides (142 mg/dL DT, 139 mg/Dl TT), LDL-C (94 mg/dL DT, 91 mg/dL TT) and HDL-C (36 mg/dL DT, 35 mg/dL TT). Changes in total cholesterol, LDL-C and HDL-C were higher in DT arm, compared to TT (32% DT vs 26% TT for cholesterol; 25% DT vs 16% TT for LDL and 33% DT vs 28% TT for HDL). Increase in triglycerides was higher in TT compared to DT (55% DT vs 92% TT) (Table 1). In TT arm LDL-C and total cholesterol elevations were lower among patients receiving TDF compared to those treated with ZDV or ABC.


CONCLUSIONS
Changes in lipid parameters were observed in both arms. Albeit the increase was numerically higher for cholesterol (total and LDL-C) in DT arm while TT arm had higher increases in TG; no difference was observed when week 48 values were compared with the NCEP ATP III goals for cardiovascular risk reduction (1). So, the DT strategy, even missing the lipid-lowering effect observed with tenofovir, does not seem to add significant risk to patients treated with this novel strategy.
Clinical Research, Fundacion Huesped, Ciudad Autónoma de Buenos Aires, Argentina.
Pedro
P
Cahn
Unidad de HIV, Hospital Civil de Guadalajara "Fray Antonio Alcalde", Guadalajara, Mexico.
Jaime Andrade
JA
Villanueva
Hospital Universitario La Paz, IdiPAZ, Madrid, Spain.
Jose
J
Arribas
Infectious Unit, Hospital Clínic/IDIBAPS, University of Barcelona, Barcelona, Spain.
Jose
J
Gatell
Clinical Research, Asociación Civil Impacta Salud y Educación (IMPACTA), Lima, Peru.
Javier
J
Lama
Virology, Global Pharmaceutical Research and Development, AbbVie, Medical Affairs Therapeutic Area, Chicago, IL, USA.
Michel
M
Norton
Clinical Research, Fundacion Huesped, Ciudad Autónoma de Buenos Aires, Argentina.
Patricia
P
Patterson
Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Juan Sierra
JS
Madero
Clinical Research, Fundacion Huesped, Ciudad Autónoma de Buenos Aires, Argentina.
Omar
O
Sued
Clinical Research, Fundacion Huesped, Ciudad Autónoma de Buenos Aires, Argentina.
Maria Ines
MI
Figueroa
Clinical Research, Fundacion Huesped, Ciudad Autónoma de Buenos Aires, Argentina.
Maria Jose
MJ
Rolón