De Socio Giuseppe Vittorio L, Bonfanti Paolo, Ricci Elena, Orofino Giancarlo, Madeddu Giordano, Penco Giovanni, Gianelli Erika, Martinelli Canio, Carradori Silvia, Quirino Tiziana, Rizzardini Giuliano
Clinica di Malattie Infettive, Università degli Studi di Perugia, Ospedale Santa Maria della Misericordia, Piazzale Menghini 1, 06129 Perugia, Italy.
Biomed Pharmacother. 2008 Jan;62(1):16-20. doi: 10.1016/j.biopha.2007.07.012. Epub 2007 Aug 21.
It is not known whether antiretroviral therapy (ART) including lopinavir/r has a different effect on the lipid metabolism in HIV patients co-infected with HCV. This study investigated changes in lipid levels, comparing patients with HIV infection alone and those with HCV too, in the lopinavir/r cohort of the SCOLTA project.
We analyzed the data for the lopinavir/r nationwide cohort from 25 Italian infectious disease departments, which comprises 743 HIV-infected patients followed prospectively, comparing subjects with HIV-HCV co-infection and those with single-infection.
At enrolment, co-infected patients had significantly lower mean cholesterol than HCV negative cases (162+/-43mg/dL vs. 185+/-52mg/dL, p=0.0009). Total and non-HDL cholesterol and triglycerides rose significantly from baseline in HIV single-infection patients, but not in those with co-infection. The patients with dual HIV-HCV infection, treated with an ART regimen including lopinavir/r, have only limited increases in total and non-HDL cholesterol and triglycerides.
Changes in serum lipids in co-infected patients differed significantly from those in patients without HCV. It remains to be seen whether this is associated with a lower risk of progression of atherosclerotic disease.
包括洛匹那韦/利托那韦在内的抗逆转录病毒疗法(ART)对合并感染丙型肝炎病毒(HCV)的HIV患者的脂质代谢是否有不同影响尚不清楚。本研究在SCOLTA项目的洛匹那韦/利托那韦队列中,比较了单纯HIV感染患者和合并HCV感染患者的血脂水平变化。
我们分析了来自25个意大利传染病科的洛匹那韦/利托那韦全国队列的数据,该队列包括743名接受前瞻性随访的HIV感染患者,比较了HIV-HCV合并感染患者和单一感染患者。
入组时,合并感染患者的平均胆固醇水平显著低于HCV阴性患者(162±43mg/dL对185±52mg/dL,p=0.0009)。HIV单一感染患者的总胆固醇、非高密度脂蛋白胆固醇和甘油三酯水平较基线显著升高,但合并感染患者则不然。接受包括洛匹那韦/利托那韦在内的ART方案治疗的HIV-HCV双重感染患者,其总胆固醇、非高密度脂蛋白胆固醇和甘油三酯仅有限升高。
合并感染患者的血脂变化与未感染HCV的患者有显著差异。这是否与动脉粥样硬化疾病进展风险较低相关仍有待观察。