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Review
. 2023 Apr 28:17:45-53.
doi: 10.33393/dti.2023.2529. eCollection 2023 Jan-Dec.

Lipid profiles of people with human immunodeficiency virus with dyslipidemia after switching from efavirenz to dolutegravir

Supphachoke Khemla  1 , Atibordee Meesing  1   2 , Wantin Sribenjalux  1   2 , Ploenchan Chetchotisakd  1
Affiliations
Review

Lipid profiles of people with human immunodeficiency virus with dyslipidemia after switching from efavirenz to dolutegravir

Supphachoke Khemla et al. Drug Target Insights. .

Abstract

Introduction:: Human immunodeficiency virus (HIV) infection and the long-term use of antiretroviral therapy, especially efavirenz (EFV)-based regimens, impact lipid profiles due to insulin resistance and lead to a higher risk of metabolic diseases. Dolutegravir (DTG) is an integrase inhibitor with better lipid profiles than EFV. However, data on treatment experience in Thailand are limited. The primary outcome was lipid profile changes at 24 weeks after switching therapy.

Methods:: We conducted a prospective, open-label, cohort study in people with HIV aged ≥18 years who had undergone at least 6 months of EFV-based therapy, had HIV-1 ribonucleic acid levels <50 copies/mL for ≥6 months before switching, and were diagnosed with dyslipidemia or had risk factors for atherosclerosis cardiovascular disease based on modified National Cholesterol Education Program Adult Treatment Panel III guidelines.

Results:: Sixty-four patients were enrolled. The mean age (standard deviation [SD]) was 48.20 ± 10.46 years, and 67.19% were male. At week 24, there were decreases from baseline in mean total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides. However, mean body weight and waist circumference had increased.

Conclusions:: DTG resulted in better lipid profiles after switching from EFV-based therapy, suggesting that this switch could benefit patients with a high risk of cardiovascular disease. However, it is essential to note that weight gain and increased waist circumference were also observed.

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Conflict of interest statement

Conflict of interest: The authors declare no competing interests.

Figures

Figure 1 -
Figure 1 -
Panel A shows the flow diagram. Panel B shows the protocols from eligible week until follow-up at week 12 and week 24. BMI = body mass index; BUN = blood urea nitrogen; BW = body weight; CBC = complete blood count; CD4 = cluster of differentiation 4; Cr = creatinine; FPG = fasting plasma glucose; HIV RNA = human immunodeficiency virus ribonucleic acid; LFT = liver function test; WC = waist circumference.
Figure 2 -
Figure 2 -
Change in mean total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, and cholesterol/HDL from baseline through week 24. HDL = high-density lipoprotein; LDL = low-density lipoprotein.
Figure 3 -
Figure 3 -
Box plot of body weight, body mass index, and waist circumference change from baseline. The horizontal line in the box interior represents the group median. The large black dot represents the group mean. (3A) body weight, (3B) body mass index, (3C) waist circumference.
See this image and copyright information in PMC

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