Changes in Lipid Profiles in Two Groups of HIV-1 Infected Patients in Cameroon on Two Treatment Regimens with Either Efavirenz or Nevirapine, in Association with Reverse Transcriptase Inhibitors

Nguemaïm, N. F.; Mbuagbaw, Josephine; Nkoa, Thérèse; Této, Georges; Njitchouang, Guy R.; Pouomogne, D. J.; Same-Ekobo, A.; Asonganyi, T

doi:10.3923/jms.2010.25.33

Cited by 3 publications

(1 citation statement)

References 29 publications

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“…The pro-inflammatory state associated with HIV infection may also give rise to atherogenic lipid changes. The lipid profile in antiretroviral-naïve HIV-infected subjects is characterized by low total cholesterol, HDL cholesterol, and LDL cholesterol, as well as elevated triglyceride levels (mainly appearing as low density lipoprotein) 12–15. Substantial evidence exists that HAART induces a hypofibrinolytic state in HIV-infected individuals, as reflected in increased plasma levels of plasminogen activator and homocystein, which are thought to be markers of atherothrombotic risk 14–16…”

Section: Discussionmentioning

confidence: 99%

Impact of short-term antiretroviral therapy (START) on some fibrinolytic markers in HIV-infected Nigerian adults: preliminary findings from the START study

Jeremiah¹,

Obazee²,

Okogun³

et al. 2012

HIV

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BackgroundDerangement in fibrinolytic markers can result in thrombosis and cardiovascular problems. Antiretroviral therapy (ART) has been reported to affect the levels of these markers. It is unclear how long a patient can be exposed to ART before the effect of the drugs on the fibrinolytic markers becomes noticeable; this short-term antiretroviral therapy (START) study aimed to answer this question.MethodsTwenty human immunodeficiency virus (HIV)-positive subjects on ART and 20 controls (non-ART) were progressively monitored for three months. CD4 T-cell count was determined while D-dimer, t-PA, and PAI-1 parameters were determined.ResultsCD4 T-cell count increased from 192 μL/mL at baseline to 323 μL/mL at month 3 among patients on ART. D-dimer concentrations decreased from 301.0 μL/mL at baseline to 172.0 μL/mL at month 2, then increased to 226.0 μL/mL at the end of the third month. The median baseline concentration of PAI-1 at the beginning of therapy was 14.0 μg/mL, which increased progressively to 18.2 μg/mL at the end of the third month. The baseline concentration of t-PA at the beginning of therapy was 5.15 μg/mL. This progressively declined to 1.10 μg/mL at the end of the first month and reached 1.45 μg/mL and 1.5 μg/mL at the end of the second and third months, respectively. D-dimer was positively and significantly correlated with CD4 cell counts in both AIDs-associated retrovirus (ARV) and non-ARV patients (r = −0.304, P < 0.01 vs r = −0.477, P < 0.001). t-PA was negatively correlated with CD4 T-lymphocytes in those undergoing ART (r = −0.294, P < 0.01).ConclusionA progressive increase in PAI-1 and steady decline in t-PA concentrations within 3 months of commencement of ART could predispose patients to thrombotic disorders earlier than is expected. Pre-thrombotic assessment during therapy is therefore advocated.

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Section: Discussionmentioning

confidence: 99%

Impact of short-term antiretroviral therapy (START) on some fibrinolytic markers in HIV-infected Nigerian adults: preliminary findings from the START study

Jeremiah¹,

Obazee²,

Okogun³

et al. 2012

HIV

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Comparative efficacy and safety of dolutegravir relative to common core agents in treatment-naïve patients infected with HIV-1: a systematic review and network meta-analysis

et al. 2019

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Background Network meta-analyses (NMAs) provide comparative treatment effects estimates in the absence of head-to-head randomized controlled trials (RCTs). This NMA compared the efficacy and safety of dolutegravir (DTG) with other recommended or commonly used core antiretroviral agents. Methods A systematic review identified phase 3/4 RCTs in treatment-naïve patients with HIV-1 receiving core agents: ritonavir-boosted protease inhibitors (PIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), or integrase strand inhibitors (INSTIs). Efficacy (virologic suppression [VS], CD4 + cell count change from baseline) and safety (adverse events [AEs], discontinuations, discontinuation due to AEs, lipid changes) were analyzed at Week 48 using Bayesian NMA methodology, which allowed calculation of probabilistic results. Subgroup analyses were conducted for VS (baseline viral load [VL] ≤/> 100,000copies/mL, ≤/> 500,000copies/mL; baseline CD4 + ≤/>200cells/μL). Results were adjusted for the nucleoside/nucleotide reverse transcriptase inhibitors (NRTI) combined with the core agent (except subgroup analyses). Results The NMA included 36 studies; 2 additional studies were included in subgroup analyses only. Odds of achieving VS with DTG were statistically superior to PIs (odds ratios [ORs] 1.78–2.59) and NNRTIs (ORs 1.51–1.86), and similar but numerically higher than other INSTIs. CD4 + count increase was significantly greater with DTG than PIs (difference: 23.63–31.47 cells/μL) and efavirenz (difference: 34.54 cells/μL), and similar to other core agents. INSTIs were more likely to result in patients achieving VS versus PIs (probability: 76–100%) and NNRTIs (probability: 50–100%), and a greater CD4 + count increase versus PIs (probability: 72–100%) and NNRTIs (probability: 60–100%). DTG was more likely to result in patients achieving VS (probability: 94–100%), and a greater CD4 + count increase (probability: 53–100%) versus other core agents, including INSTIs (probability: 94–97% and 53–93%, respectively). Safety outcomes with DTG were generally similar to other core agents. In patients with baseline VL > 100,000copies/mL or ≤ 200 CD4 + cells/μL (18 studies), odds of achieving VS with DTG were superior or similar to other core agents. Conclusion INSTI core agents had superior efficacy and similar safety to PIs and NNRTIs at Week 48 in treatment-naïve patients with HIV-1, with DTG being among the most efficacious, including in patients with baseline VL > 100,000copies/mL or ≤ 200 CD4 + cells/μL, who can be difficult to treat. Electronic supplementary material The online version of this article (10.1186/s12879-019-3975-6) contains supplementary material, which is available to authorized users.

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The in vivo and in vitro Developmental Toxicity and Teratogenicity of the Anti-AIDS Drugs (Human and Experimental Animal Studies)

Mobarak¹

2011

Trends in Applied Sciences Research

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Changes in Lipid Profiles in Two Groups of HIV-1 Infected Patients in Cameroon on Two Treatment Regimens with Either Efavirenz or Nevirapine, in Association with Reverse Transcriptase Inhibitors

Cited by 3 publications

References 29 publications

Impact of short-term antiretroviral therapy (START) on some fibrinolytic markers in HIV-infected Nigerian adults: preliminary findings from the START study

Impact of short-term antiretroviral therapy (START) on some fibrinolytic markers in HIV-infected Nigerian adults: preliminary findings from the START study

Comparative efficacy and safety of dolutegravir relative to common core agents in treatment-naïve patients infected with HIV-1: a systematic review and network meta-analysis

The in vivo and in vitro Developmental Toxicity and Teratogenicity of the Anti-AIDS Drugs (Human and Experimental Animal Studies)

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