Atherogenic properties of lipoproteins in HIV patients starting atazanavir/ritonavir or darunavir/ritonavir: A substudy of the ATADAR randomized study

Maria Saumoy, Jordi Ordóñez-Llanos, Esteban Martínez, Elena Ferrer, Pere Domingo, Esteban Ribera, Eugenia Negredo, Jordi Curto, José Luis Sánchez-Quesada, Silvana Di Yacovo, Ana Gonzá Lez-Cordón, Daniel Podzamczer

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Abstract

© The Author 2014. Objectives: To assess LDL subfraction phenotype and lipoprotein-associated phospholipase A2 (Lp-PLA2) in naive HIV-infected patients starting atazanavir/ritonavir or darunavir/ritonavir plus tenofovir/emtricitabine. Methods: This was a substudy of a multicentre randomized study. Standard lipid parameters, LDL subfraction phenotype (by gradient gel electrophoresis) and Lp-PLA2 activity (by 2-thio-PAF) were measured at baseline and weeks 24 and 48. Multivariate regression analysis was performed. Results are expressed as the median (IQR). Results: Eighty-six (atazanavir/ritonavir, n=45; darunavir/ritonavir, n=41) patients were included: age 36 (31-41) years; 89% men; CD4 319 (183-425) cells/mm3; and Framingham score 1% (0%-2%). No differences in demographics or lipidmeasurements were found at baseline. At week 48, a mild but significant increase in total cholesterol and HDL-cholesterol was observed in both arms, whereas LDL cholesterol increased only in the darunavir/ritonavir arm and triglycerides only in the atazanavir/ritonavir arm. The apolipoprotein A-I/apolipoprotein B ratio increased only in the atazanavir/ritonavir arm. At week 48, the LDL subfraction phenotype improved in the darunavir/ritonavir arm (increase in LDL particle size and in large LDL particles), whereas it worsened in the atazanavir/ritonavir arm (increase in small and dense LDL particles, shift to a greater prevalence of phenotype B); the worsening was related to the greater increase in triglycerides in the atazanavir/ritonavir arm. No changes in total Lp-PLA2 activity or relative distribution in LDL or HDL particles were found at week 48 in either arm. Conclusions: In contrast with what occurred in the atazanavir/ritonavir arm, the LDL subfraction phenotype improved with darunavir/ritonavir at week 48. This difference was associated with a lower impact on plasma triglycerides with darunavir/ritonavir.
Original languageEnglish
Pages (from-to)1130-1138
JournalJournal of Antimicrobial Chemotherapy
Volume70
Issue number4
DOIs
Publication statusPublished - 16 Sep 2014

Keywords

  • LDL size
  • LDL subfraction phenotype
  • Lipoprotein-associated phospholipase A2

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    Saumoy, M., Ordóñez-Llanos, J., Martínez, E., Ferrer, E., Domingo, P., Ribera, E., Negredo, E., Curto, J., Sánchez-Quesada, J. L., Di Yacovo, S., Lez-Cordón, A. G., & Podzamczer, D. (2014). Atherogenic properties of lipoproteins in HIV patients starting atazanavir/ritonavir or darunavir/ritonavir: A substudy of the ATADAR randomized study. Journal of Antimicrobial Chemotherapy, 70(4), 1130-1138. https://doi.org/10.1093/jac/dku501