Lipid profile changes in Thai HIV and tuberculosis co-infected patients receiving non-nucleoside reverse transcriptase inhibitors-based antiretroviral therapy

摘要

Objective: To study and compare the pattern of lipid profile changes in Thai HIV and tuberculosis (TB) co-infected patients after receiving two non-nucleoside reverse transcriptase inhibitors (NNRTIs)-based antiretroviral therapy (ART). Material and Method: From an open label, randomized, comparative trial comparing treatment outcome between HIV and TB co-infected patients receiving nevirapine (NVP) or efavirenz (EFV) combined with stavudine and lamivudine, patient's body mass index (BMI), CD4 cell count, plasma HIV-1 RNA, fasting blood glucose, plasma total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and triglyceride (TG) were collected at baseline, 24, and 48 weeks of ART. Results: Of the 121 patients included in the present study, mean (SD) age was 36.9 (8.4) years and 66% were male. After 48 weeks of ART, the median (IQR) percentage of TC, LDL-C, HDL-C and TG values were 21.1% (5.4-40.7), 23.5% (-0.8-49.8), 22.7% (0-50) and -1.0% (-34.6-32.2) respectively. The median (IQR) percentage change of the HDL-C value was significantly higher in NVP-based than EFV-based ART (31.9 [9.6-50.0] vs. 12.2 [-8.8-51.2]; p = 0.03). The proportions of patients with high TC (21.5%) and high LDL-C (29.2%) increased and low HDL-C (11.6%) decreased significantly at 48 weeks of ART, compared to baseline (all, p < 0.01). The proportions of patients with high TC, high TG and low HDL-C were significantly higher in the EFV group than in the NVP group (p = 0.03 for high TC, p = 0.01 for high TG and p < 0.01 for low HDL-C). Conclusion: NNRTI-based ART is associated with increases of TC, LDL-C and HDL-C values in Thai HIV and TB co-infected patients. More favorable lipid profile is observed in NVP-based than EFV-based ART.