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Ocampo A, Domingo P, Fernández P, Diz J, Barberá JR, Sepúlveda MA, Salgado X, Rodriguez M, Santos J, Yzusqui M, Mayorga MI, Lorenzo JF, Bahamonde A, Bachiller P, Martínez E, Rozas N, Torres C, Muñoz A, Casado A, Podzamczer D. Lipid changes and tolerability in a cohort of adult HIV-infected patients who switched to rilpivirine/emtricitabine/tenofovir due to intolerance to previous combination ART: the PRO-STR study. J Antimicrob Chemother 2019; 73:2171-2176. [PMID: 29788066 DOI: 10.1093/jac/dky175] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 04/16/2018] [Indexed: 01/15/2023] Open
Abstract
Objectives To analyse lipid changes and tolerability in a cohort of HIV-infected patients who switched their antiretroviral regimens to rilpivirine/emtricitabine/tenofovir (RPV/FTC/TDF) in a real-world setting. Methods PRO-STR is a 48 week prospective observational post-authorization study in 25 hospitals. Patients with a viral load <1000 copies/mL, receiving at least 12 months of combination ART (cART), with constant posology for at least the prior 3 months, were categorized according to previous treatment [NNRTI or ritonavir-boosted PI (PI/r)]. Analytical tests were performed at the baseline visit, between week 16 and week 32, and at week 48. Results A total of 303 patients were included (mean age 46.6 years; male 74.0%; previous treatment 74.7% NNRTI and 25.3% PI/r). Both groups exhibited significantly reduced lipid profiles, except for HDL cholesterol, for which a non-significant increase was observed. [NNRTI patients: total cholesterol (baseline: 195.5 ± 38.4 mg/dL; week 48: 171.0 ± 35.5 mg/dL), total cholesterol/HDL ratio (baseline: 4.2 ± 1.2; week 48: 4.0 ± 1.2), HDL (baseline: 49.1 ± 12.0 mg/dL; week 48: 49.2 ± 45.8 mg/dL), LDL (baseline: 119.2 ± 30.2 mg/dL; week 48: 114.2 ± 110.7 mg/dL), and triglycerides (baseline: 136.6 ± 86.8 mg/dL; week 48: 113.4 ± 67.8 mg/dL); PI/r patients: total cholesterol (baseline: 203.2 ± 48.8 mg/dL; week 48: 173.4 ± 36.9 mg/dL), total cholesterol/HDL ratio (baseline: 4.7 ± 1.6; week 48: 4.0 ± 1.2), HDL (baseline: 46.4 ± 12.5 mg/dL; week 48: 52.1 ± 54.4 mg/dL), LDL (baseline: 127.0 ± 36.3 mg/dL; week 48: 111.4 ± 35.8 mg/dL), and triglycerides (baseline: 167.6 ± 107.7 mg/dL; week 48: 122.7 ± 72.1 mg/dL)]. The most common intolerances were neuropsychiatric in the NNRTI patients and gastrointestinal and metabolic in the PI/r patients, and these intolerances were significantly reduced in both groups at week 48 [NNRTI: neuropsychiatric (baseline: 81.3%; week 48: 0.0%); PI/r: gastrointestinal (baseline: 48.7%; week 48: 0.0%) and metabolic (baseline: 42.1%; week 48: 0.0%)]. Conclusions RPV/FTC/TDF improved the lipid profiles and reduced the intolerances after switching from NNRTI or PI-based regimens, in a cohort of HIV-infected patients.
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Affiliation(s)
- A Ocampo
- Xeral de Vigo Hospital, Pontevedra, Spain
| | - P Domingo
- de la Santa Creu y Sant Pau Hospital, Barcelona, Spain
| | | | - J Diz
- de Montecelo Hospital, A Coruña, Spain
| | - J R Barberá
- La Mancha Centro Hospital, Ciudad Real, Spain
| | | | - X Salgado
- University de Girona Dr Josep Trueta Hospital, Girona, Spain
| | | | - J Santos
- Virgen de la Victoria Hospital, Málaga, Spain
| | - M Yzusqui
- Nuestra Señora del Prado Hospital, Toledo, Spain
| | | | | | | | - P Bachiller
- University del Río Hortega Hospital, Valladolid, Spain
| | - E Martínez
- University de Albacete Hospital, Albacete, Spain
| | - N Rozas
- University de Bellvitge, Barcelona Hospital, Barcelona, Spain
| | - C Torres
- Pharmacoeconomics & Outcomes Research Iberia, Madrid, Spain
| | - A Muñoz
- Pharmacoeconomics & Outcomes Research Iberia, Madrid, Spain
| | - A Casado
- Pharmacoeconomics & Outcomes Research Iberia, Madrid, Spain
| | - D Podzamczer
- University de Bellvitge, Barcelona Hospital, Barcelona, Spain
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