Impact of Lopinavir/Ritonavir and Efavirenz-Based Antiretroviral Therapy on the Lipid Profile of Chinese HIV/AIDS Treatment-Naive Patients in Beijing: A Retrospective Study
Impact of Lopinavir/Ritonavir and Efavirenz-Based Antiretroviral Therapy on the Lipid Profile of Chinese HIV/AIDS Treatment-Naive Patients in Beijing: A Retrospective Study
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DOI：
10.2174/1570162x17666191025115508
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发表时间：
2019-01-01
影响因子：
1
通讯作者：
Sun, Lijun
中科院分区：
文献类型：
--
作者：
Dai, Lili;Liu, An;Sun, Lijun
背景：抗逆转录病毒治疗（ART）与脂质异常相关，脂质异常导致人类免疫缺陷病毒(HIV)/获得性免疫缺陷综合征（AIDS）患者心血管（CV）事件的风险增加。尽管在发达国家已有与抗逆转录病毒治疗相关的脂质代谢紊乱的报道，但在中国，与抗逆转录病毒治疗相关的脂质谱紊乱的数据有限。本研究旨在研究以洛匹那韦/利托那韦LPV/r或依非韦伦（EFV）为基础的抗逆转录病毒治疗方案在中国和其他发展中国家继续广泛使用的HIV/AIDS患者的血脂变化。方法：对2012年7月至2017年1月在首都医科大学附属北京佑安医院接受LPV/r或EFV治疗的hiv阳性患者进行回顾性匹配病例对照研究。采用广义估计方程比较两个治疗组在基线和抗逆转录病毒治疗开始后24个月时总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白-胆固醇（LDL-C）和高密度脂蛋白-胆固醇（HDL-C）的差异。结果：基线特征，包括年龄、性别、CD4细胞计数、病毒载量和血脂，在两组之间具有可比性。治疗24个月后，以LPV/r为基础的治疗组TC、TG、HDL-C和LDL-C均升高。efv治疗组TC、HDL-C、LDL-C较基线升高，TC/HDL-C比值降低，TG无明显变化。治疗24个月后，LPV/r组出现血脂异常的患者比例明显高于EFV组(84.0% vs. 52.6%， P
Background: Antiretroviral therapy (ART) is associated with lipid abnormalities that contribute to increased risk of cardiovascular (CV) events among patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Although disorders of lipid metabolism associated with ART have been described before in developed countries, data on lipid profile disorders associated with ART use in China are limited. This study aimed to examine the changes in lipid profile among patients with HIV/AIDS who initiated lopinavir/ritonavir LPV/r or efavirenz (EFV)-based antiretroviral treatment regimens, which continue to be widely used China and other developing countries.Methods: This is a retrospective, matched case-control study of HIV-positive patients initiating either LPV/r or EFV regimens at the Beijing You'an Hospital, Capital Medical University between July 2012 and January 2017. Generalized estimating equations were used to compare the differences in total cholesterol [TC], triglycerides [TG], low-density lipoprotein-cholesterol [LDL-C], and high-density lipoprotein-cholesterol [HDL-C] at baseline and up to 24-months after ART initiation between the two treatment arms.Results: Baseline characteristics, including age, sex, CD4 cell count, viral load, and serum lipids, which were comparable between the two groups. The LPV/r-based regimen group had increased TC, TG, HDL-C, and LDL-C after 24-months of treatment. In the EFV-regimen group, TC, HDL-C, and LDL-C were increased compared to baseline, while the TC/HDL-C ratio decreased, and TG did not change significantly. After 24-months of treatment, the percentage of patients with dyslipidemia in the LPV/r group was much higher than in the EFV group (84.0% vs. 52.6%, P