Lopinavir plasma concentrations and changes in lipid levels during salvage therapy with lopinavir/ritonavir-containing regimens
Lopinavir plasma concentrations and changes in lipid levels during salvage therapy with lopinavir/ritonavir-containing regimens
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DOI：
10.1097/00126334-200308150-00007
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发表时间：
2003-08-15
影响因子：
3.6
通讯作者：
Martin-Hidalgo, A
中科院分区：
文献类型：
--
作者：
Gutiérrez, F;Padilla, S;Martin-Hidalgo, A
目的：为了确定是否存在关联洛匹那韦（LPV）血浆浓度和血脂level.Design的变化之间的关系：一个前瞻性的，nonrandomized study.Subjects：HIV感染的受试者与病毒学失败的蛋白酶通道含方案。连续22例患者入组，19个完成了24周的治疗，16个完成了完整的48周的研究period.Intervention：患者与LPV/利托那韦（LPV/r）与其他抗逆转录病毒药物联合治疗。在基线和第4、8、12、24、36和48周评价受试者。结果：LPV谷浓度在3级或3级以上血脂升高的患者中较高（平均值[SD]：9.71 mug/mL（5.62）vs 6.09 mug/mL（3.83）; P = 0.002）和2级或更高级别高胆固醇血症患者（平均值[SD]：8.48 mug/mL [4.64] vs. 5.71 mug/mL [3.94]; P = 0.003）。所有发生2级或2级以上胆固醇升高的患者在第4周时的LPV谷浓度均大于8 mug/mL。LPV谷浓度和甘油三酯和胆固醇水平的变化之间存在显着的正相关性。结论：在接受LPV/r挽救治疗的患者中，LPV血浆浓度和脂质变化之间存在相关性。达到较高LPV谷浓度的患者发生血脂异常的风险可能更大。需要进一步调查以支持直接因果关系。
Objective: To determine whether an association existed between lopinavir (LPV) plasma concentrations and changes in lipid levels.Design: A prospective, nonrandomized study.Subjects: HIV-infected subjects with virologic failure on protease inhibitor-containing regimens. Twenty-two consecutive patients were enrolled, 19 completed 24 weeks of treatment, and 16 completed the full 48-week study period.Intervention: Patients were treated with LPV/ritonavir (LPV/r) in combination with other antiretroviral agents. Subjects were evaluated at baseline and weeks 4, 8, 12, 24, 36, and 48. LPV trough plasma concentrations and lipid levels were measured.Results: LPV trough concentrations were higher in patients experiencing grade 3 or higher lipid elevations (mean [SD]: 9.71 mug/mL (5.62) vs. 6.09 mug/mL (3.83); P = 0.002) and in those developing grade 2 or higher hypercholesterolemia (mean [SD]: 8.48 mug/mL [4.64] vs. 5.71 mug/mL [3.94]; P = 0.003). All patients developing grade 2 or higher cholesterol elevation had an LPV trough concentration at week 4 greater than 8 mug/mL. Significant positive correlations were found between LPV trough concentrations and changes in triglyceride and cholesterol levels.Conclusions: In patients receiving salvage therapy with LPV/r, there is an association between LPV plasma concentrations and lipid changes. Patients achieving higher LPV trough concentrations may be at greater risk of experiencing dyslipidemia. Further investigations are warranted to support a direct cause and effect relationship.