title: Lipid-lowering effect and changes in estimated cardiovascular risk after switching to a tenofovir-containing regimen for the treatment of HIV-infected patients.
abstract: Tenofovir could have a direct lipid-lowering effect. The aim of our retrospective study was to investigate changes in cardiovascular risk after switching from a tenofovir-sparing to a tenofovir-containing backbone. Lipid parameters and cardiovascular risk [calculated using 10-years Framingham Risk Score (FRS) and 5-years DAD Risk Score (DRS)] were analysed at baseline and after three months. 273 patients were enrolled. After switching, significant decreases in total cholesterol (TC) (-8.2mg/dl, p < 0.001), LDL (-8.7mg/dl, p < 0.001) and DRS (mean -0.26%, p < 0.001) were observed, while a reduction in FRS was only observed in patients with pre-switch high TC or medium-high (>10%) FRS. Pre-switch factors associated with DRS reduction were higher TC, abacavir, new generation protease inhibitors, while zidovudine predicted an increase of DRS. Our results suggest that the improvement of lipid parameters observed after switching to a tenofovir-containing backbone could lead to a significant reduction in predicted cardiovascular risk, which became more evident in subjects with higher cardiovascular risk.
authors.affiliation: a Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart , Rome , Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Gagliardini
authors.affiliation: b Division of Infectious Diseases, San Gerardo Hospital , University of Milano-Bicocca , Monza , Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Fabbiani
authors.affiliation: c Infectious Dermatology and Allergology Unit, IFO S. Gallicano Institute (IRCCS) , Rome , Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Colafigli
authors.affiliation: a Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart , Rome , Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: D'Avino
authors.affiliation: a Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart , Rome , Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Mondi
authors.affiliation: a Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart , Rome , Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Borghetti
authors.affiliation: a Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart , Rome , Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Lamonica
authors.affiliation: a Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart , Rome , Italy.
authors.forename: Roberto
authors.identifier: http://orcid.org/0000-0002-1498-4229
authors.initials: R
authors.lastname: Cauda
authors.affiliation: a Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart , Rome , Italy.|d Infectious Diseases Unit, Azienda Ospedaliera Universitaria Senese , Siena , Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: De Luca
authors.affiliation: a Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart , Rome , Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Di Giambenedetto
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D002318:Cardiovascular Diseases / Q000097:blood* / Q000517:prevention & control*; D015224:Dideoxynucleosides / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000627:therapeutic use; D015497:HIV-1 / Q000187:drug effects; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D000068698:Tenofovir / Q000627:therapeutic use*; D000099227:Abacavir
chemical_list: D019380:Anti-HIV Agents; D015224:Dideoxynucleosides; D017320:HIV Protease Inhibitors; D008055:Lipids; D000068698:Tenofovir; D000099227:Abacavir
keywords: Cardiovascular risk; Cholesterol; DAD risk score; Dyslipidemia; Framingham risk score; HAART