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Endothelial function in human immunodeficiency virus-infected antiretroviral-naive subjects before and after starting potent antiretroviral therapy: The ACTG (AIDS Clinical Trials Group) Study 5152s.
- Source :
-
Journal of the American College of Cardiology [J Am Coll Cardiol] 2008 Aug 12; Vol. 52 (7), pp. 569-76. - Publication Year :
- 2008
-
Abstract
- Objectives: This study evaluated the effects of 3 class-sparing antiretroviral therapy (ART) regimens on endothelial function in human immunodeficiency virus (HIV)-infected subjects participating in a randomized trial.<br />Background: Endothelial dysfunction has been observed in patients receiving ART for HIV infection.<br />Methods: This was a prospective, multicenter study of treatment-naive subjects who were randomly assigned to receive a protease inhibitor-sparing regimen of nucleoside reverse transcriptase inhibitors (NRTIs) + efavirenz, a non-nucleoside reverse transcriptase inhibitor-sparing regimen of NRTIs + lopinavir/ritonavir, or a NRTI-sparing regimen of efavirenz + lopinavir/ritonavir. The NRTIs were lamivudine + stavudine, zidovudine, or tenofovir. Brachial artery flow-mediated dilation (FMD) was determined by B-mode ultrasound before starting on ART, then after 4 and 24 weeks.<br />Results: There were 82 subjects (median age 35 years, 91% men, 54% white). Baseline CD4 cell counts and plasma HIV ribonucleic acid (RNA) values were 245 cells/mm(3) and 4.8 log(10) copies/ml, respectively. At baseline, FMD was 3.68% (interquartile range [IQR] 1.98% to 5.51%). After 4 and 24 weeks of ART, plasma HIV RNA decreased by 2.1 and 3.0 log(10) copies/ml, respectively. FMD increased by 0.74% (IQR -0.62% to +2.74%, p = 0.003) and 1.48% (IQR -0.20% to +4.30%, p < 0.001), respectively, with similar changes in each arm (Kruskal-Wallis p value >0.600). The decrease in plasma HIV RNA at 24 weeks was associated with greater FMD (r(s) = -0.30, p = 0.017).<br />Conclusions: Among treatment-naive individuals with HIV, 3 different ART regimens rapidly improved endothelial function. Benefits were similar for all ART regimens, appeared quickly, and persisted at 24 weeks.
- Subjects :
- Adenine administration & dosage
Adenine analogs & derivatives
Adult
Alkynes
Benzoxazines administration & dosage
Brachial Artery drug effects
Brachial Artery physiopathology
CD4 Lymphocyte Count
Cyclopropanes
Endothelium, Vascular pathology
Female
HIV Protease Inhibitors administration & dosage
HIV-1
Humans
Lamivudine administration & dosage
Lopinavir
Male
Organophosphonates administration & dosage
Prospective Studies
Pyrimidinones administration & dosage
Ritonavir administration & dosage
Stavudine administration & dosage
Tenofovir
Time Factors
Zidovudine administration & dosage
Anti-HIV Agents administration & dosage
Endothelium, Vascular drug effects
HIV Infections drug therapy
HIV Infections physiopathology
Reverse Transcriptase Inhibitors administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1558-3597
- Volume :
- 52
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Journal of the American College of Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 18687253
- Full Text :
- https://doi.org/10.1016/j.jacc.2008.04.049