Impact
of Boosted vs Unboosted Atazanavir-based Regimens on the Lipid Profiles of HIV
Positive Patients There
are scant data on the effect of HAART regimens containing ritonavir-boosted versus
unboosted atazanavir (Reyataz)
on the lipid
profiles of HIV positive patients in clinical practice.
The primary
objective of the current study, presented at the XVI International AIDS Conference
in Toronto, was to compare lipid changes at 3 months in patients taking boosted
and unboosted atazanavir. The secondary objective was to compare lipid changes
in patients with different baseline lipid levels.
Canadian researchers
conducted a retrospective chart review of patients taking regimens containing
unboosted atazanavir or atazanavir/ritonavir. Participants who started lipid-lowering
agents or who had any changes in their doses of lipid-lowering agents while on
atazanavir were excluded. Demographic and clinical data were collected.
Results
Baseline
characteristics (prior to initiating or switching to atazanavir) and lipid levels
at baseline and 3 months after starting atazanavir are shown in the following
chart:
|
|
Unboosted atazanavir
(N=28) |
Atazanavir/ritonavir (N=67) |
|
Males:
Females |
17:11 |
54:13 |
|
Mean
age (years) |
50 |
47 |
|
Number
of treatment-naive patients |
2 |
6 |
|
Number
of patients with viral load < 50 copies/mL |
17 |
49 |
|
Number
of patients on d4T (stavudine, Zerit) |
5 |
11 |
|
Mean
baseline TC (mmol/L) +/- SD |
5.46 +/- 2.07 |
5.5 +/- 1.60 |
|
Mean
baseline* TG (mmol/L) +/- SD |
3.65 +/- 6.87 |
3.4 +/- 3.03 |
|
Mean
3-month follow-up TC (mmol/L) +/- SD |
5.08 +/- 1.23 |
5.38 +/- 1.29 |
|
Mean
3-month follow-up TG (mmol/L) +/- SD |
2.29 +/- 3.34 |
3.09 +/- 2.48 | TC = total
cholesterol TG = triglycerides |
For triglyceride levels, there was a significant decrease over time when both
atazanavir groups were combined (P = 0.015).
There was no difference in the triglyceride decrease between patients taking boosted
and unboosted atazanavir.
For total cholesterol, there was a non-significant decrease over time when both
groups were combined.
Here too, there was no difference in the total cholesterol decrease between the
two groups.
Adding baseline dyslipidemia
(abnormal lipid levels) into the model did not affect the results.
Conclusion The
authors concluded, "There does not appear to be a difference between atazanavir
and atazanavir/ritonavir [in their effect] on total cholesterol and triglycerides
over the first 3 months of therapy." The
Ottawa Hospital, Pharmacy Department, Ottawa, Canada, The Ottawa Hospital, Infectious
Diseases Department, Ottawa, Canada, University of Ottawa, Faculty of Health Sciences,
School of Nursing, Ottawa, Canada. 08/29/06 Reference
J
Drummond, L Beique, K Woodend, and others. Impact of atazanavir versus atazanavir/ritonavir-based
regimens on the lipid profile of HIV patients in clinical practice. XVI International
AIDS Conference. Toronto, August 13-18, 2006. Abstract CDB0712.
| 
