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.

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 ±âŸ38.4 mg/dL; week 48 171.0 ±âŸ35.5 mg/dL), total cholesterol/HDL ratio (baseline 4.2 ±âŸ1.2; week 48 4.0 ±âŸ1.2), HDL (baseline 49.1 ±âŸ12.0 mg/dL; week 48 49.2 ±âŸ45.8 mg/dL), LDL (baseline 119.2 ±âŸ30.2 mg/dL; week 48 114.2 ±âŸ110.7 mg/dL), and triglycerides (baseline 136.6 ±âŸ86.8 mg/dL; week 48 113.4 ±âŸ67.8 mg/dL); PI/r patients total cholesterol (baseline 203.2 ±âŸ48.8 mg/dL; week 48 173.4 ±âŸ36.9 mg/dL), total cholesterol/HDL ratio (baseline 4.7 ±âŸ1.6; week 48 4.0 ±âŸ1.2), HDL (baseline 46.4 ±âŸ12.5 mg/dL; week 48 52.1 ±âŸ54.4 mg/dL), LDL (baseline 127.0 ±âŸ36.3 mg/dL; week 48 111.4 ±âŸ35.8 mg/dL), and triglycerides (baseline 167.6 ±âŸ107.7 mg/dL; week 48 122.7 ±âŸ72.1 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.