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JAC Advance Access originally published online on August 21, 2007
Journal of Antimicrobial Chemotherapy 2007 60(4):824-830; doi:10.1093/jac/dkm285
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© The Author 2007. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Impact of steady-state lopinavir plasma levels on plasma lipids and body composition after 24 weeks of lopinavir/ritonavir-containing therapy free of thymidine analogues

A. León1,*, E. Martinez1, M. Sarasa2, Y. López2, J. Mallolas1, E. De Lazzari3, M. Laguno1, A. Milincovic1, J. L. Blanco1, M. Larrousse1, M. Lonca1 and J. M. Gatell1

1 Infectious Diseases Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain 2 Clinical Pharmacology Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain 3 Biostatistic Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain

Received 3 February 2007; returned 10 April 2007; revised 4 July 2007; accepted 6 July 2007

* Corresponding author. Tel: +34-93-2275574; Fax: +34-93-4515424; E-mail: aleon{at}clinic.ub.es

Objectives: To study the impact of lopinavir/ritonavir-containing therapy on plasma lipids and body fat of HIV-infected adults and to assess whether lopinavir plasma levels at steady state are correlated with plasma lipids and body fat after 24 weeks.

Methods: Patients had their antiretroviral therapy switched to an antiretroviral regimen containing lopinavir/ritonavir plus one or two non-thymidine analogues. Body composition was assessed by dual energy X-ray absorptiometry at baseline and at week 24 and an intensive pharmacokinetic (PK) 12 h profile was performed at week 2.

Results: Twenty-six patients were included. Plasma triglycerides (from 206 mg/dL to 261 mg/dL, P = 0.09) and total cholesterol (from 201 to 206 mg/dL, P = 0.03) increased from baseline to week 24. There was a significant rise in total fat (from 10.9 to 11.9 kg, P = 0.02) and limb fat (from 3.8 to 4.4 kg, P = 0.02) from baseline to week 24. We did not find any correlation between PK lopinavir levels and changes over time for triglycerides, cholesterol or body fat composition.

Conclusions: There was an increase in plasma triglycerides and total cholesterol levels and a gain in both total and limb fat at 24 weeks, but these changes were not correlated with lopinavir plasma levels.

Keywords: pharmacokinetic parameters , body composition , hypertriglyceridaemia , hypercholesterolaemia


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