Metabolic abnormalities and cardiovascular risk in HIV-infected cohort of patients treated with protease inhibitors

AimAim of this study was to evaluate cardiovascular risk in HIV-infected patients treated with atazanavir or lopinavir, both boosted with ritonavir, in Poland.BackgroundIntroduction into clinical practice of cART has succeeded in decline in AIDS-related mortality and extended the life expectancy of patients living with HIV/AIDS. Observed, anyhow, side effects such as dyslipidemia and, as a result, cardiovascular disease seems to become predominant cause of mortality in this population.Materials and methodsThe study was a retrospective data analysis of HIV infected patients on ATV/r or LPV/r, treated between 1st of November 2004 and 31st of March 2009, and continued this treatment for at least 24 weeks.ResultsThe study population included 328 patients (82 women and 246 men) within age range between 23 and 75 years (mean 38.5 ± 9.2 years) divided into two groups: group A (148 patients on atazanavir 300 mg + ritonavir 100 mg/d) and group B (180 patients treated with lopinavir/ritonavir 800/200 mg/d).Changes in the level of cholesterol, triglycerides and glucose were significantly different in the treatment groups (p-value: 0.01, 0.009, 0.02 respectively). SCORE scale increase during observation did not differ statistically (p = 0.53). Increase in cholesterol and triglyceride levels was higher in the group B (17.0% vs 7.8% and 41.5% vs 16.8%) while the increase in the level of glucose was in the group A (5.2% vs 0.7%).ConclusionThe study confirms differences in CV risk factors between different cART drugs and this should be considered during initiation of the therapy.