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

Research output: Contribution to journalArticle

1 Citation (Scopus)

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 languageEnglish (US)
Pages (from-to)175-183
Number of pages9
JournalHIV Medicine
Volume19
Issue number3
DOIs
StatePublished - Mar 1 2018

Fingerprint

Ritonavir
Protease Inhibitors
Acquired Immunodeficiency Syndrome
Cohort Studies
HIV
Pediatrics
Lipids
HDL Cholesterol
Cholesterol
LDL Cholesterol
Atazanavir Sulfate
Darunavir
Nelfinavir
Lopinavir
Dyslipidemias
Fasting
Triglycerides
Cardiovascular Diseases
Therapeutics

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 journalArticle

@article{e2a703b399ea47b9a9a5199a2bbd8714,
title = "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",
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.",
keywords = "atazanavir, children, darunavir, lipids, longitudinal, perinatally HIV-infected",
author = "{the Pediatric HIV/AIDS Cohort Study (PHACS) Adolescent Master Protocol (AMP) study} and J. Jao and W. Yu and K. Patel and Miller, {Tracie L} and B. Karalius and Geffner, {M. E.} and DiMeglio, {L. A.} and A. Mirza and Chen, {J. S.} and M. Silio and McFarland, {E. J.} and {Van Dyke}, {R. B.} and D. Jacobson and Ram Yogev and Ann Sanders and Kathleen Malee and Scott Hunter and William Shearer and Mary Paul and Norma Cooper and Lynnette Harris and Murli Purswani and Mahboobullah Baig and Anna Cintron and Ana Puga and Sandra Navarro and Garvie, {Patricia A.} and James Blood and Burchett, {Sandra K.} and Nancy Karthas and Betsy Kammerer and Andrew Wiznia and Marlene Burey and Molly Nozyce and Arry Dieudonne and Linda Bettica and Garcia Bulkley and Latreaca Ivey and Mitzie Grant and Katherine Knapp and Kim Allison and Megan Wilkins and Midnela Acevedo-Flores and Heida Rios and Vivian Olivera and Medea Gabriel and Patricia Sirois and Spector, {Stephen A.} and Scott, {Gwendolyn B} and Anai Cuadra",
year = "2018",
month = "3",
day = "1",
doi = "10.1111/hiv.12566",
language = "English (US)",
volume = "19",
pages = "175--183",
journal = "HIV Medicine",
issn = "1464-2662",
publisher = "Wiley-Blackwell",
number = "3",

}

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 -