Abstract
Objectives: Dyslipidaemia is common in perinatally HIV-infected (PHIV) youth receiving protease inhibitors (PIs). Few studies have evaluated longitudinal lipid changes in PHIV youth after switch to newer PIs. Methods: We compared longitudinal changes in fasting lipids [total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and TC:HDL-C ratio] in PHIV youth enrolled in the Pediatric HIV/AIDS Cohort Study (PHACS) Adolescent Master Protocol (AMP) study who switched to atazanavir/ritonavir (ATV/r)- or darunavir/ritonavir (DRV/r)-based antiretroviral therapy (ART) from an older PI-based ART and those remaining on an older PI. Generalized estimating equation models were fitted to assess the association of a switch to ATV/r- or DRV/r-based ART with the rate of change in lipids, adjusted for potential confounders. Results: From 2007 to 2014, 47 PHIV children/adolescents switched to ATV/r or DRV/r, while 120 remained on an older PI [primarily lopinavir/r (72%) and nelfinavir (24%)]. Baseline age ranged from 7 to 21 years. After adjustment for age, Tanner stage, race/ethnicity, and HIV RNA level, a switch to ATV/r or DRV/r was associated with a more rapid annual rate of decline in the ratio of TC:HDL-C. (β = −0.12; P = 0.039) than remaining on an older PI. On average, TC declined by 4.57 mg/dL/year (P = 0.057) more in the switch group. A switch to ATV/r or DRV/r was not associated with the rate of HDL-C, LDL-C, or TG change. Conclusions: A switch to ATV/r or DRV/r may result in more rapid reduction in TC and the TC:HDL-C ratio in PHIV youth, potentially impacting long-term cardiovascular disease risk.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 175-183 |
| Number of pages | 9 |
| Journal | HIV Medicine |
| Volume | 19 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2018 |
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Keywords
- atazanavir
- children
- darunavir
- lipids
- longitudinal
- perinatally HIV-infected
ASJC Scopus subject areas
- Health Policy
- Infectious Diseases
- Pharmacology (medical)
Cite this
Improvement in lipids after switch to boosted atazanavir or darunavir in children/adolescents with perinatally acquired HIV on older protease inhibitors : results from the Pediatric HIV/AIDS Cohort Study. / the Pediatric HIV/AIDS Cohort Study (PHACS) Adolescent Master Protocol (AMP) study.
In: HIV Medicine, Vol. 19, No. 3, 01.03.2018, p. 175-183.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Improvement in lipids after switch to boosted atazanavir or darunavir in children/adolescents with perinatally acquired HIV on older protease inhibitors
T2 - results from the Pediatric HIV/AIDS Cohort Study
AU - the Pediatric HIV/AIDS Cohort Study (PHACS) Adolescent Master Protocol (AMP) study
AU - Jao, J.
AU - Yu, W.
AU - Patel, K.
AU - Miller, Tracie L
AU - Karalius, B.
AU - Geffner, M. E.
AU - DiMeglio, L. A.
AU - Mirza, A.
AU - Chen, J. S.
AU - Silio, M.
AU - McFarland, E. J.
AU - Van Dyke, R. B.
AU - Jacobson, D.
AU - Yogev, Ram
AU - Sanders, Ann
AU - Malee, Kathleen
AU - Hunter, Scott
AU - Shearer, William
AU - Paul, Mary
AU - Cooper, Norma
AU - Harris, Lynnette
AU - Purswani, Murli
AU - Baig, Mahboobullah
AU - Cintron, Anna
AU - Puga, Ana
AU - Navarro, Sandra
AU - Garvie, Patricia A.
AU - Blood, James
AU - Burchett, Sandra K.
AU - Karthas, Nancy
AU - Kammerer, Betsy
AU - Wiznia, Andrew
AU - Burey, Marlene
AU - Nozyce, Molly
AU - Dieudonne, Arry
AU - Bettica, Linda
AU - Bulkley, Garcia
AU - Ivey, Latreaca
AU - Grant, Mitzie
AU - Knapp, Katherine
AU - Allison, Kim
AU - Wilkins, Megan
AU - Acevedo-Flores, Midnela
AU - Rios, Heida
AU - Olivera, Vivian
AU - Gabriel, Medea
AU - Sirois, Patricia
AU - Spector, Stephen A.
AU - Scott, Gwendolyn B
AU - Cuadra, Anai
PY - 2018/3/1
Y1 - 2018/3/1
N2 - Objectives: Dyslipidaemia is common in perinatally HIV-infected (PHIV) youth receiving protease inhibitors (PIs). Few studies have evaluated longitudinal lipid changes in PHIV youth after switch to newer PIs. Methods: We compared longitudinal changes in fasting lipids [total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and TC:HDL-C ratio] in PHIV youth enrolled in the Pediatric HIV/AIDS Cohort Study (PHACS) Adolescent Master Protocol (AMP) study who switched to atazanavir/ritonavir (ATV/r)- or darunavir/ritonavir (DRV/r)-based antiretroviral therapy (ART) from an older PI-based ART and those remaining on an older PI. Generalized estimating equation models were fitted to assess the association of a switch to ATV/r- or DRV/r-based ART with the rate of change in lipids, adjusted for potential confounders. Results: From 2007 to 2014, 47 PHIV children/adolescents switched to ATV/r or DRV/r, while 120 remained on an older PI [primarily lopinavir/r (72%) and nelfinavir (24%)]. Baseline age ranged from 7 to 21 years. After adjustment for age, Tanner stage, race/ethnicity, and HIV RNA level, a switch to ATV/r or DRV/r was associated with a more rapid annual rate of decline in the ratio of TC:HDL-C. (β = −0.12; P = 0.039) than remaining on an older PI. On average, TC declined by 4.57 mg/dL/year (P = 0.057) more in the switch group. A switch to ATV/r or DRV/r was not associated with the rate of HDL-C, LDL-C, or TG change. Conclusions: A switch to ATV/r or DRV/r may result in more rapid reduction in TC and the TC:HDL-C ratio in PHIV youth, potentially impacting long-term cardiovascular disease risk.
AB - Objectives: Dyslipidaemia is common in perinatally HIV-infected (PHIV) youth receiving protease inhibitors (PIs). Few studies have evaluated longitudinal lipid changes in PHIV youth after switch to newer PIs. Methods: We compared longitudinal changes in fasting lipids [total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and TC:HDL-C ratio] in PHIV youth enrolled in the Pediatric HIV/AIDS Cohort Study (PHACS) Adolescent Master Protocol (AMP) study who switched to atazanavir/ritonavir (ATV/r)- or darunavir/ritonavir (DRV/r)-based antiretroviral therapy (ART) from an older PI-based ART and those remaining on an older PI. Generalized estimating equation models were fitted to assess the association of a switch to ATV/r- or DRV/r-based ART with the rate of change in lipids, adjusted for potential confounders. Results: From 2007 to 2014, 47 PHIV children/adolescents switched to ATV/r or DRV/r, while 120 remained on an older PI [primarily lopinavir/r (72%) and nelfinavir (24%)]. Baseline age ranged from 7 to 21 years. After adjustment for age, Tanner stage, race/ethnicity, and HIV RNA level, a switch to ATV/r or DRV/r was associated with a more rapid annual rate of decline in the ratio of TC:HDL-C. (β = −0.12; P = 0.039) than remaining on an older PI. On average, TC declined by 4.57 mg/dL/year (P = 0.057) more in the switch group. A switch to ATV/r or DRV/r was not associated with the rate of HDL-C, LDL-C, or TG change. Conclusions: A switch to ATV/r or DRV/r may result in more rapid reduction in TC and the TC:HDL-C ratio in PHIV youth, potentially impacting long-term cardiovascular disease risk.
KW - atazanavir
KW - children
KW - darunavir
KW - lipids
KW - longitudinal
KW - perinatally HIV-infected
UR - http://www.scopus.com/inward/record.url?scp=85034596955&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85034596955&partnerID=8YFLogxK
U2 - 10.1111/hiv.12566
DO - 10.1111/hiv.12566
M3 - Article
C2 - 29159965
AN - SCOPUS:85034596955
VL - 19
SP - 175
EP - 183
JO - HIV Medicine
JF - HIV Medicine
SN - 1464-2662
IS - 3
ER -