Relationship between plasma bilirubin level and oxidative stress markers in HIV‐infected patients on atazanavir‐ vs. efavirenz‐based antiretroviral therapy. Issue 9 (3rd March 2016)

• Record Type: Journal Article
• Authors: Estrada, V; Monge, S; Gómez‐Garre, MD; Sobrino, P; Masiá, M; Berenguer, J; Portilla, J; Viladés, C; Martínez, E; Blanco, JR
• Other Names: Moreno Santiago investigator.; del Amo Julia investigator.; Dalmau David investigator.; Navarro Maria Luisa investigator.; González Maria Isabel investigator.; Garcia Federico investigator.; Rubio Rafael investigator.; Iribarren Jose Antonio investigator.; Gutiérrez Félix investigator.; Vidal Francesc investigator.; González Juan investigator.; Hernando Victoria investigator.; Alejos Belén investigator.; Álvarez Débora investigator.; Jarrín Inma investigator.; Rivero Yaiza investigator.; González Cristina investigator.; Ángeles Muñoz‐Fernández M. investigator.; García‐Merino Isabel investigator.; Rico Coral Gómez investigator.; Merino Esperanza investigator.; Reus Sergio investigator.; Boix Vicente investigator.; Giner Livia investigator.; Gadea Carmen investigator.; Portilla Irene investigator.; Pampliega Maria investigator.; Díez Marcos investigator.; Rodríguez Juan Carlos investigator.; Sánchez‐Payá Jose investigator.; Gutiérrez Félix investigator.; Padilla Sergio investigator.; Navarro Andrés investigator.; Montolio Fernando investigator.; Robledano Catalina investigator.; Colomé Joan Gregori investigator.; Adsuar Araceli investigator.; Pascual Rafael investigator.; Martinez Maravillas investigator.; de Quirós Juan Carlos López Bernaldo investigator.; Miralles Pilar investigator.; Gutiérrez Isabel investigator.; Ramírez Margarita investigator.; Padilla Belén investigator.; Gijón Paloma investigator.; Carrero Ana investigator.; Aldamiz‐Echevarría Teresa investigator.; Tejerina Francisco investigator.; Parras Francisco Jose investigator.; Balsalobre Pascual investigator.; Diez Cristina investigator.; Vidal Francesc investigator.; Peraire Joaquín investigator.; Veloso Sergio investigator.; Vargas Montserrat investigator.; López‐Dupla Miguel investigator.; Olona Montserrat investigator.; Aguilar Alba investigator.; Sirvent Joan Josep investigator.; Alba Verónica investigator.; Calavia Olga investigator.; González Juan investigator.; de la Serna Ignacio Bernardino investigator.; Arribas José Ramón investigator.; Montes María Luisa investigator.; Peña Jose Mª investigator.; Arribas Blanca investigator.; Castro Juan Miguel investigator.; Zamora Fco Javier investigator.; Pérez Ignacio investigator.; Estébanez Miriam investigator.; García Silvia investigator.; Díaz Marta investigator.; Alcáriz Natalia Stella investigator.; Mingorance Jesús investigator.; Montero Dolores investigator.; González Alicia investigator.; de José Maria Isabel investigator.; Hontañón Victor investigator.; Casado José Luis investigator.; Dronda Fernando investigator.; Moreno Ana investigator.; Elías María Jesús Pérez investigator.; López Dolores investigator.; Gutiérrez Carolina investigator.; Hernández Beatriz investigator.; Madrid Nadia investigator.; Lamas Angel investigator.; Martí Paloma investigator.; de Diaz Alberto investigator.; Serrrano Sergio investigator.; Donat Lucas investigator.; Cano Alfredo investigator.; Bernal Enrique investigator.; Muñoz Ángeles investigator.; Santos Jesús investigator.; Márquez Manuel investigator.; Viciana Isabel investigator.; Palacios Rosario investigator.; Pérez Isabel investigator.; González Carmen Maria investigator.; Viciana Pompeyo investigator.; Leal Manuel investigator.; López‐Cortés Luis Fernando investigator.; Trastoy Mónica investigator.; Espinosa Nuria investigator.;
• Is Part Of: HIV medicine. Volume 17:Issue 9(2016:Oct.)
• Page Start: 653
• Page End: 661
• Publication Date: 2016-03-03
• Subjects: atazanavir -- bilirubin -- efavirenz -- oxidative stress -- prospective studies; HIV infections -- Treatment -- Periodicals; HIV-positive persons -- Periodicals; HIV infections -- Treatment -- Decision making -- Periodicals; 616.9792
• DOI: 10.1111/hiv.12368
• Languages: English
• ISSNs: 1464-2662

Abstract

Abstract : Objectives: Chronic oxidative stress (OS) may play a role in cardiovascular disease in HIV‐infected patients, and increased bilirubin levels may have a beneficial role in counteracting OS. Atazanavir (ATV) inhibits UDP‐glucuronosyl‐transferase 1A1 (UGT1A1), thus increasing unconjugated bilirubin levels. We aimed to compare changes in OS markers in patients on ATV/ritonavir (ATV/r)‐ vs . efavirenz (EFV)‐based first‐line antiretroviral therapy (ART). Methods: A multicentre, prospective cohort study of HIV‐infected patients who started first‐line ART with either ATV/r or EFV was conducted. Lipoprotein‐associated phospholipase A2 (Lp‐PLA2), myeloperoxidase (MPO) and oxidized low‐density lipoprotein (oxLDL) were measured for 145 patients in samples obtained at baseline and after at least 9 months of ART during which the initial regimen was maintained and the patient was virologically suppressed. The change in OS markers was modelled using multiple linear regressions adjusting for baseline values and confounders. Results: After adjustment for baseline variables, patients on ATV/r had a significantly greater decrease in Lp‐PLA2 [estimated difference −16.3; 95% confidence interval (CI) −31.4, −1.25; P = 0.03] and a significantly smaller increase in OxLDL (estimated difference −21.8; 95% CI −38.0, −5.6; P < 0.01) relative to those on EFV, whereas changes in MPO were not significantly different (estimated difference 1.2; 95% CI −14.3, 16.7; P = 0.88). Adjusted changes in bilirubin were significantly greater for the ATV/r group than for the EFV group (estimated difference 1.33 mg/dL; 95% CI 1.03, 1.52 mg/dL; P < 0.01). Changes in bilirubin and changes in OS markers were significantly correlated. Conclusions: When compared with EFV, ATV/r‐based therapy was associated with lower levels of oxidative stress biomarkers, which was in part attributable to increased bilirubin levels.