Atherogenicity of low-density lipoproteins after switching from a protease inhibitor to dolutegravir: a substudy of the NEAT022 study.
J Antimicrob Chemother
; 77(7): 1980-1988, 2022 06 29.
Article
in En
| MEDLINE
| ID: mdl-35411401
ABSTRACT
BACKGROUND:
The aim of this study was to investigate whether switching from a ritonavir-boosted PI-based regimen to a dolutegravir-based regimen improved the atherogenic properties of LDL particles in patients with HIV.METHODS:
This was a substudy of the NEAT022 study (ClinicalTrials.gov NCT02098837). Adults with HIV with a Framingham score >10% or aged >50â years and being treated with a stable boosted PI-based regimen were randomized to either switch to dolutegravir or continue with boosted PI. At baseline and Week 48, we assessed atherogenic LDL properties LDL particle size and phenotype (A, intermediate, B), oxidized LDL (ox-LDL) and lipoprotein-associated phospholipase A2 (Lp-PLA2) activity.RESULTS:
Eighty-six participants (dolutegravir 44; PI 42) were included. Participants had a median (IQR) age of 54 (51-57) years and 79.1% were male. In the dolutegravir arm, after 48â weeks, we observed (1) an increase in LDL size [median 1.65â Å (IQR -0.60 to 4.20); Pâ=â0.007], correlated with the decrease in triglyceride concentration [Spearman correlationâ=â-0.352 (Pâ=â0.001)], with a corresponding decrease of subjects with atherogenic LDL phenotype B (36.4% to 20.5%; Pâ=â0.039); (2) a decrease in Lp-PLA2 activity [median 1.39â µmol/min/mL (IQR -2.3 to 0.54); Pâ=â0.002]; and (3) a decrease in ox-LDL [median 14â U/L (IQR -102 to 13); Pâ=â0.006]. In the PI arm, none of these favourable lipid modifications was observed.CONCLUSIONS:
Forty-eight weeks after switching from a PI-based to a dolutegravir-based regimen, patients with Framingham score >10% or aged >50â years showed improvement of several atherogenic lipid features, including LDL particle phenotype, ox-LDL and Lp-PLA2.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
HIV Infections
/
Anti-HIV Agents
/
Atherosclerosis
/
Lipoproteins, LDL
Type of study:
Clinical_trials
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Antimicrob Chemother
Year:
2022
Document type:
Article
Affiliation country:
Spain