Improvement of lipid profiles when switching from efavirenz to rilpivirine in HIV-infected patients with dyslipidemia. Issue 1 (2nd January 2016)

• Record Type: Journal Article
• Authors: Thamrongwonglert, Pornpimol; Chetchotisakd, Ploenchan; Anunnatsiri, Siriluck; Mootsikapun, Piroon
• Is Part Of: HIV clinical trials. Volume 17:Issue 1(2016)
• Page Start: 12
• Page End: 16
• Publication Date: 2016-01-02
• Subjects: rilpivirine -- switching therapy -- dyslipidemia -- efavirenz; HIV Infections -- Chemotherapy -- Periodicals; AIDS (Disease) -- Chemotherapy -- Periodicals; HIV Infections -- Research -- Periodicals; AIDS (Disease) -- Research -- Periodicals; 616.979206105
• DOI: 10.1080/15284336.2015.1112480
• Languages: English
• ISSNs: 1528-4336

Abstract

Abstract : Rilpivirine (RPV) is a non-nucleoside reverse transcriptase inhibitor, which has better lipid profiles than efavirenz (EFV) in treatment naïve patients. However, the data on treatment experience are limited especially in dyslipidemic HIV patients; thus, we aimed to assess the change of lipid profiles after switching from EFV to RPV in these patients. In this prospective, open-label, cohort study, we enrolled HIV-1 infected adults who had received at least 6 months of EFV-based regimen, with HIV RNA <50 copies/mL for ≥6 months prior to switching. The objectives of this study were to analyze lipid changes and to evaluate the efficacy, safety, tolerability at 24 weeks after switching therapy. Fifty-three patients were enrolled and completed the study. At week 24, a significant decrease in the mean (95% confident interval, CI) total cholesterol (−28.06 mg/dL, 95%CI −35.20 to −20.91, p < 0.0001), LDL-cholesterol (−20.96 mg/dL, 95%CI −28.12 to −13.80, p < 0.0001), high-density lipoprotein (HDL)-cholesterol (−5.11 mg/dL, 95%CI −7.79 to −2.44, p < 0.0001), and triglyceride (−29.79 mg/dL. 95%CI −52.39 to −7.19, p = 0.011) levels were observed. One patient had virologic rebound with HIV RNA of 114 copies/mL at week 24. Three (5.7%) patients had grade 2 elevations of liver enzymes. None of the patients discontinued RPV during the study. Switching from EFV-based therapy to RPV-based regimen improved lipid profiles in fully suppressed HIV patients with dyslipidemia. This treatment should be considered in these patients.