JAC Advance Access published online on August 21, 2007
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkm285
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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
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.
Key Words: pharmacokinetic parameters , body composition , hypertriglyceridaemia , hypercholesterolaemia
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