与使用HIV蛋白酶抑制剂相关的高脂血症：自然病程及非诺贝特治疗结果

Hyperlipidemia related to the use of HIV-protease inhibitors: natural history and results of treatment with fenofibrate.

作者信息

Caramelli B, de Bernoche C Y, Sartori A M, Sposito A C, Santos R D, Monachini M C, Strabelli T, Uip D

机构信息

Heart Institute (InCor) and AIDS Clinic, University of São Paulo Medical School, São Paulo, Brazil.

出版信息

Braz J Infect Dis. 2001 Dec;5(6):332-8. doi: 10.1590/s1413-86702001000600007.

DOI:10.1590/s1413-86702001000600007

PMID:11980596

Abstract

Hyperlipidemia has been frequently recorded as a side effect of treating HIV patients with protease inhibitors (PI). This study was initiated to analyze the modifications on blood lipids in HIV-patients receiving PI and the safety and efficacy of the treatment with fenofibrate. Total (TC) and HDL-cholesterol, triglycerides (TG), and CD(4)(+) T-cell counts were measured in 30 HAART-naive patients (Group I) before and after PI introduction. In a second phase of the study, the effects of fenofibrate on lipids, CPK, CD(4)(+), and viral load were determined in 13 patients (Group II) with elevated TC or TG. In Group I, 60% of the patients showed TC or TG elevations. Average increments of 31% and 146% in TC and TG respectively (p<0.0006 and p<0.0001) were observed. In Group II, fenofibrate treatment was associated with decrements of 6.6% (TC) and 45.7% (TG) (p=0.07 and 0.0002) and no modifications on CPK, CD(4)(+), and viral load. In conclusion, hyperlipidemia is common during the treatment of HIV with protease inhibitors, and fenofibrate appears to be an effective and safe choice for its treatment.

摘要

高脂血症经常被记录为用蛋白酶抑制剂（PI）治疗HIV患者的一种副作用。开展这项研究是为了分析接受PI治疗的HIV患者血脂的变化以及非诺贝特治疗的安全性和有效性。在30例初治抗逆转录病毒治疗（HAART）患者（第一组）引入PI之前和之后测量总胆固醇（TC）、高密度脂蛋白胆固醇、甘油三酯（TG）以及CD4(+) T细胞计数。在研究的第二阶段，在13例TC或TG升高的患者（第二组）中确定非诺贝特对血脂、肌酸磷酸激酶（CPK）、CD4(+)和病毒载量的影响。在第一组中，60%的患者出现TC或TG升高。分别观察到TC和TG平均升高31%和146%（p<0.0006和p<0.0001）。在第二组中，非诺贝特治疗使TC降低6.6%，TG降低45.7%（p=0.07和0.0002），并且对CPK、CD4(+)和病毒载量无影响。总之，在用蛋白酶抑制剂治疗HIV期间高脂血症很常见，非诺贝特似乎是其治疗的一种有效且安全的选择。