[Efectiveness and safety of switching to raltegravir-based regimen in dyslipidemic HIV-infected patients receiving antiretroviral therapy at Arriaran Foundation]

Rev Chilena Infectol. 2019 Aug;36(4):490-495. doi: 10.4067/S0716-10182019000400490.
[Article in Spanish]

Abstract

Background: The impact of switching antiretroviral therapy (ART) regimen for dyslipidemia management in HIV-infected (HIV+) patients has not been reported in Chile.

Aim: To assess effectiveness and safety at 12 months after switching to raltegravir-based regimen for dyslipidemia management.

Methods: Retrospective cohort of HIV+ patients receiving ART at Arriaran Foundation, with dyslipidemia switched to raltegravir-based regimen for lipid management.

Results: 73 patients were included, receiving ART based in nonnucleoside reverse transcriptase inhibitor (NNRTI; 50,7%) or protease inhibitor (PI; 49,3%), with mixed dyslipidemia (42,5%) or isolated hypertriglyceridemia (57,5%). At baseline, median total cholesterol (TC) and triglycerides (TG) were 228 mg/dl and 420 mg/dl, respectively; undetectable viral load (VL) was present in 94,5% of patients. Backbone ART was switched in 58,4% and lipid-lowering therapy was used by 89,1% of them. At 12 months, there was a significant decrease in TG (-43,6%) and TC (-19,3%). No cases of virologic failure were observed, although 10,9% of patients had detectable VL at 12 months, mostly transient.

Conclusions: Switching ART to raltegravir-based regimen in dyslipidemic patients receiving NNRTI or PI is associated with a significative decrease in TG and TC at 12 months. This strategy is safe, but VL can be increased temporarily.

MeSH terms

  • Adult
  • Anti-HIV Agents / administration & dosage*
  • Antiretroviral Therapy, Highly Active / methods*
  • CD4 Lymphocyte Count
  • Cohort Studies
  • Dyslipidemias / prevention & control*
  • Female
  • Follow-Up Studies
  • HIV Infections / blood
  • HIV Infections / drug therapy*
  • HIV Protease Inhibitors / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Raltegravir Potassium / administration & dosage*
  • Retrospective Studies
  • Viral Load

Substances

  • Anti-HIV Agents
  • HIV Protease Inhibitors
  • Raltegravir Potassium