Lopinavir/ritonavir combination and total/HDL cholesterol ratio

• Published in: The Journal of infection 2005-04, Vol.50 (3), p.229-235
• Main Authors: Valerio, Laure, Fontas, Eric, Pradier, Christian, Lavrut, Thibaud, Garraffo, Rodolphe, Dunais, Brigitte, Cua, Eric, Dellamonica, Pierre
• Format: Article
• Language: English
• Subjects: Adult; Cholesterol - blood; Cholesterol, HDL - blood; Drug Combinations; Drug Monitoring; Female; HIV Infections - blood; HIV Infections - drug therapy; HIV Protease Inhibitors - adverse effects; Humans; Hyperlipidemia; Hyperlipidemias - chemically induced; Lopinavir; Male; Middle Aged; Pyrimidinones - administration & dosage; Pyrimidinones - adverse effects; Pyrimidinones - blood; Retrospective Studies; Ritonavir - administration & dosage; Ritonavir - adverse effects; Time Factors
• ISSN: 0163-4453; 1532-2742
• DOI: 10.1016/j.jinf.2004.01.014

Objectives. To describe the evolution of the lipidic profile among LPV/r treated patients in a ‘real life’ situation. Methods. Lipids measurements at LPV/r initiation time and every 3 months, and pharmacological measurements at M3 and M6 were collected retrospectively in 142 patients attending our clinic. Dyslipidaemia was defined as total cholesterol ≥6.2 mmol/l, HDL-cholesterol ≥1 mmol/l, total/HDL-cholesterol ratio ≥6.5 and triglycerides ≥2.3 mmol/l. Results. Eighty-nine percent of patients had previously received a regimen with protease inhibitors, 4% were treatment naı̈ve. At baseline, 17% of patients had high total cholesterol, 49% high triglycerides, 63% low HDL-cholesterol, 25% a high total/HDL-cholesterol ratio. At M12, the mean HDL-cholesterol increase per patient was 21%. Lipids levels significantly increased over the study period, as early as the 3rd month (6th month for ratio) and continuously until the 12th month. Among the patients with available LPV/r plasma determinations at M3, a higher lopinavir residual concentration was observed in those with high triglycerides (6.78 vs 3.02 mg/l, p=0.05) as, at M6, in those with an elevated ratio (9.19 vs 0.96 mg/l, p=0.02). Conclusions. Those results suggest that LPV/r may induce a significant rise in the total/HDL-cholesterol ratio, despite an increase in HDL-cholesterol levels. The association between triglycerides and total/HDL-cholesterol ratio elevated levels and high residual concentrations of lopinavir may also argue for systematic drug monitoring.