title: Atherogenic properties of LDL particles after switching from Truvada or Kivexa plus lopinavir/r to lamivudine plus lopinavir/r: OLE-MET substudy.
abstract: The objective of this study was to determine the impact of tenofovir or abacavir discontinuation on low-density lipoprotein (LDL) phenotype and lipoprotein-associated phospholipase A2 (Lp-PLA2) activity in HIV-infected patients treated with lopinavir/ritonavir plus 2 nucleos(t)ide reverse transcriptase inhibitors (NRTI).
  
  
  
  Multicenter, open-label study. Patients were randomized to continue with lopinavir/ritonavir plus 2 NRTI (triple therapy) or to switch to lopinavir/ritonavir plus lamivudine (dual therapy). LDL phenotype (by gradient gel electrophoresis) and Lp-PLA2 (by 2-thio-PAF) were determined at baseline and week 48.
  
  
  
  Forty-four patients included (triple therapy n = 19, dual therapy n = 25): men 63.6%, age 41.5 years (25-61), Framingham score 4.9% (0.2-22). Tenofovir was part of the regimen in 28 (63.6%) patients. Dual therapy patients were younger (p = 0.013) and had lower baseline apolipoprotein A1 (p = 0.029). At week 48, there were no changes in standard lipid measurements, except ApoA1/Apo B, which increased in dual therapy (p = 0.038) with no differences between arms. At week 48, no change in LDL phenotype was found in either arm. No changes in total Lp-PLA2 activity or the relative distribution of LDL and HDL particles were found at week 48 in either arm.
  
  
  
  Discontinuing the third nucleos(t)ide, mainly tenofovir and abacavir, in a lopinavir/ritonavir-containing regimen was not associated with a deleterious effect on LDL phenotype nor in Lp-PLA2 activity.
authors.affiliation: a HIV and STD Unit, Infectious Disease Service , Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL) , L'Hospitalet de Llobregat , Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Saumoy
authors.affiliation: a HIV and STD Unit, Infectious Disease Service , Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL) , L'Hospitalet de Llobregat , Spain.
authors.forename: Juan M
authors.initials: JM
authors.lastname: Tiraboschi
authors.affiliation: b Biochemistry Department , Biomedical Research Institute IIB Sant Pau , Barcelona , Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Ordoñez-Llanos
authors.affiliation: c Infectious Disease Service , Hospital Universitari Vall d'Hebron, Universitat Autónoma de Barcelona , Barcelona , Spain.
authors.forename: Esteban
authors.initials: E
authors.lastname: Ribera
authors.affiliation: d Department of Infectious Diseases , Hospitals Universitaris Arnau de Vilanova & Santa Maria, Institut de Recerca Biomèdica (IRBLLEIDA), Universitat de Lleida , Lleida , Spain.
authors.forename: Pere
authors.initials: P
authors.lastname: Domingo
authors.affiliation: e Infectious Disease Service , Hospital Clínic , Barcelona , Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Mallolas
authors.affiliation: a HIV and STD Unit, Infectious Disease Service , Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL) , L'Hospitalet de Llobregat , Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Curto
authors.affiliation: e Infectious Disease Service , Hospital Clínic , Barcelona , Spain.
authors.forename: Josep M
authors.initials: JM
authors.lastname: Gatell
authors.affiliation: a HIV and STD Unit, Infectious Disease Service , Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL) , L'Hospitalet de Llobregat , Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Podzamczer
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood / Q000378:metabolism; D019380:Anti-HIV Agents; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D015415:Biomarkers; D018791:CD4 Lymphocyte Count; D015224:Dideoxynucleosides / Q000008:administration & dosage / Q000009:adverse effects*; D004338:Drug Combinations; D057915:Drug Substitution; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism*; D006801:Humans; D019259:Lamivudine / Q000008:administration & dosage / Q000009:adverse effects*; D050356:Lipid Metabolism / Q000187:drug effects; D008055:Lipids / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood / Q000378:metabolism*; D061466:Lopinavir / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D019562:Viral Load; D000099227:Abacavir
chemical_list: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase; D019380:Anti-HIV Agents; D015415:Biomarkers; D015224:Dideoxynucleosides; D004338:Drug Combinations; D019259:Lamivudine; D008055:Lipids; D008077:Lipoproteins, LDL; D061466:Lopinavir; C492871:abacavir, lamivudine drug combination; D000099227:Abacavir
keywords: Abacavir; LDL particles; Lipid profile; Lipoprotein-associated phospholipase A2; Lopinavir/ritonavir; Switch strategy; Tenofovir