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JAC Advance Access published online on March 10, 2005
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dki063
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JAC © The British Society for Antimicrobial Chemotherapy 2005; all rights reserved
Received November 14, 2004
Revised January 12, 2005
Accepted January 18, 2005

Brief report

Lipid disorders in antiretroviral-naive patients treated with lopinavir/ritonavir-based HAART: frequency, characterization and risk factors

Maria Luisa Montes 1, Federico Pulido 2, Carlos Barros 3, Emilia Condes 3, Rafael Rubio 2, Concepción Cepeda 2, Fernando Dronda 4, Antonio Antela 4, José Sanz 5, Enrique Navas 4, Pilar Miralles 6, Juan Berenguer 6, Susana Pérez 4, Angeles Zapata 7, Juan J. González-García 1, Jose Ma Peña 1, J. J. Vázquez 1, and Jose R. Arribas 1*

1 Internal Medicine Service, La Paz Hospital, Autónoma University School of Medicine, Madrid, Spain
2 HIV Unit, Hospital 12 de Octubre, Complutense University School of Medicine, Madrid, Spain
3 Hospital de Móstoles, Alcalá University School of Medicine, Madrid, Spain
4 Servicio de Enfermedades Infecciosas, Hospital Ramón y Cajal, Alcalá University School of Medicine, Madrid, Spain
5 Internal Medicine Service, Hospital Príncipe de Asturias, Alcalá University School of Medicine, Madrid, Spain
6 Servicio de Enfermedades Infecciosas, Hospital Gregorio Marañón, Complutense University School of Medicine, Madrid, Spain
7 Biochemistry Service, La Paz Hospital, Autónoma University School of Medicine, Spain

* To whom correspondence should be addressed.
Jose R. Arribas, E-mail: josearribas{at}telefonica.net


  Abstract

Objectives: The aim of this study was to evaluate the frequency, characteristics and risk factors of lipid changes associated with lopinavir/ritonavir treatment in antiretroviral-naive patients.

Methods: A prospective cohort of 107 antiretroviral-naive HIV-infected patients was followed for 12 months after starting lopinavir/ritonavir-based highly active antiretroviral therapy.

Results: At 12 months, percentages of patients with hypercholesterolaemia and hypertriglyceridaemia were 17.4% and 40%, respectively. Mean increases in total cholesterol and triglycerides were 40.7 and 73.3 mg/dL. There was a significant increase in both low-density and high-density (HDL) cholesterol, and no increase in the total cholesterol/HDL ratio (from 4.16 at baseline to 4.49 after 12 months). Baseline cholesterol > 200 mg/dL and triglycerides > 150 mg/dL were independent risk factors for dyslipidaemia, while hepatitis C coinfection appeared to be protective.

Conclusions: Patients with elevated lipid values at baseline have the greatest risk of developing hypercholesterolaemia and hypertriglyceridaemia after starting lopinavir/ritonavir. Antiretroviral-naive patients coinfected with hepatitis C have a low risk of developing hyperlipidaemia after starting lopinavir/ritonavir.

Keywords: antiretroviral therapy; hypercholesterolaemia; hypertriglyceridaemia; cholesterol; triglycerides; high-density cholesterol; low-density cholesterol.
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