Incidence of dyslipidemia in people with HIV who are treated with integrase inhibitors versus other antiretroviral agents
Por:
Byonanebye, DM, Polizzotto, MN, Begovac, J, Grabmeier-Pfistershammer, K, Abela, I, Castagna, A, De Wit, S, Mussini, C, Vehreschild, JJ, Monforte, AD, Wit, FWNM, Pradier, C, Chkhartishvili, N, Sonnerborg, A, Hoy, J, Lundgren, J, Neesgaard, B, Bansi-matharu, L, Greenberg, L, Llibre, JM, Vannappagari, V, Gallant, J, Necsoi, C, Cichon, P, Reiss, P, Aho, I, Tsertsvadze, T, Mennozzi, M, Rauch, A, Muccini, C, Law, M, Mocroft, A, Ryom, L and Petoumenos, K
Publicada:
1 may 2021
Resumen:
Objective: To compare the incidence of dyslipidemia in people with HIV receiving integrase inhibitors (INSTI) versus boosted protease inhibitors (PI/b) and nonnucleoside reverse transcriptase inhibitors (NNRTI) within RESPOND consortium of prospective cohorts. Methods: Participants were eligible if they were at least 18 years, without dyslipidemia and initiated or switched to a three-drug antiretroviral therapy (ART)-regimen consisting of either INSTI, NNRTI, or PI/b for the first time, between 1 January 2012 and 31 December 2018. Dyslipidemia was defined as random total cholesterol more than 240 mg/dl, HDL less than 35 mg/dl, triglyceride more than 200 mg/dl, or initiation of lipid-lowering therapy. Poisson regression was used to determine the adjusted incidence rate ratios. Follow-up was censored after 3 years or upon ART-regimen discontinuation or last lipid measurement or 31 December 2019, whichever occurred first. Results: Overall, 4577 people with HIV were eligible (INSTI = 66.9%, PI/b = 12.5%, and NNRTI = 20.6%), 1938 (42.3%) of whom were ART-naive. During 1.7 (interquartile range, 0.6-3.0) median years of follow-up, 1460 participants developed dyslipidemia [incidence rate: 191.6 per 1000 person-years, 95% confidence interval (CI) 182.0-201.7]. Participants taking INSTI had a lower incidence of dyslipidemia compared with those on PI/b (adjusted incidence rate ratio 0.71; CI 0.59-0.85), but higher rate compared with those on NNRTI (1.35; CI 1.15-1.58). Compared with dolutegravir, the incidence of dyslipidemia was higher with elvitegravir/cobicistat (1.20; CI 1.00-1.43) and raltegravir (1.24; CI 1.02-1.51), but lower with rilpivirine (0.77; CI 0.63-0.94). Conclusion: In this large consortium of heterogeneous cohorts, dyslipidemia was less common with INSTI than with PI/b. Compared with dolutegravir, dyslipidemia was more common with elvitegravir/cobicistat and raltegravir, but less common with rilpivirine.
Filiaciones:
Byonanebye, DM:
Univ New South Wales, Kirby Inst, Sydney, NSW, Australia
Makerere Univ, Sch Publ Hlth, Kampala, Uganda
Polizzotto, MN:
Univ New South Wales, Kirby Inst, Sydney, NSW, Australia
Begovac, J:
Univ Zagreb, Univ Hosp Infect Dis Dr Fran Mihaljevie, Sch Med, Zagreb, Croatia
Grabmeier-Pfistershammer, K:
Med Univ Wien, Vienna, Austria
Abela, I:
Univ Zurich, Zurich, Switzerland
Univ Hosp Zurich, Zurich, Switzerland
Castagna, A:
Univ Vita Salute San Raffaele, San Raffaele Sci Inst, Milan, Italy
De Wit, S:
Univ Libre Bruxelles, Dept Infect Dis, St Pierre Univ Hosp Bruxelles, Brussels, Belgium
Mussini, C:
Univ Modena, Modena, Italy
Vehreschild, JJ:
Univ Hosp Cologne, Cologne, Germany
Monforte, AD:
ASST Santi Paolo & Carlo, Milan, Italy
Wit, FWNM:
Stichting HIV Monitoring SHM, Amsterdam, Netherlands
Pradier, C:
Cote Azur Univ, Nice, France
Univ Hosp Ctr, Nice, France
Chkhartishvili, N:
Georgian Natl AIDS Hlth Informat Syst AIDS HIS, Infect Dis, AIDS & Clin Immunol Res Ctr, Tbilisi, Georgia
Sonnerborg, A:
Karolinska Univ Hosp, Stockholm, Sweden
Hoy, J:
Alfred Hosp, Dept Infect Dis, Melbourne, Vic, Australia
Monash Univ, Melbourne, Vic, Australia
Lundgren, J:
Univ Copenhagen, Dept Infect Dis, Rigshosp, CHIP, Copenhagen, Denmark
Neesgaard, B:
Univ Copenhagen, Dept Infect Dis, Rigshosp, CHIP, Copenhagen, Denmark
Bansi-matharu, L:
UCL, Ctr Clin Res Epidemiol Modelling & Evaluat CREME, Inst Global Hlth, London, England
Greenberg, L:
UCL, Ctr Clin Res Epidemiol Modelling & Evaluat CREME, Inst Global Hlth, London, England
:
Hosp Badalona Germans Trias & Pujol, Dept Infect Dis, Barcelona, Spain
Vannappagari, V:
ViiV Healthcare, Res Triangle Pk, NC USA
Gallant, J:
Gilead Sci, Foster City, CA USA
Necsoi, C:
Univ Libre Bruxelles, Dept Infect Dis, St Pierre Univ Hosp Bruxelles, Brussels, Belgium
Cichon, P:
Med Univ Wien, Vienna, Austria
Reiss, P:
Stichting HIV Monitoring SHM, Amsterdam, Netherlands
Aho, I:
Helsinki Univ Hosp, Helsinki, Finland
Tsertsvadze, T:
Georgian Natl AIDS Hlth Informat Syst AIDS HIS, Infect Dis, AIDS & Clin Immunol Res Ctr, Tbilisi, Georgia
Mennozzi, M:
Univ Modena, Modena, Italy
Rauch, A:
Bern Univ Hosp, Dept Infect Dis, Inselspital, Bern, Switzerland
Muccini, C:
Univ Vita Salute San Raffaele, San Raffaele Sci Inst, Milan, Italy
Law, M:
Univ New South Wales, Kirby Inst, Sydney, NSW, Australia
Mocroft, A:
UCL, Ctr Clin Res Epidemiol Modelling & Evaluat CREME, Inst Global Hlth, London, England
Ryom, L:
Univ Copenhagen, Dept Infect Dis, Rigshosp, CHIP, Copenhagen, Denmark
Petoumenos, K:
Univ New South Wales, Kirby Inst, Sydney, NSW, Australia
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