Methods: In this prospective, open-label, cohort study, we enrolled HIV-1 infected adults who had received at least 6 months of EFV-based regimen, with HIV RNA <50 copies/mL for ≥6 months prior to switching. The primary objectives of this study were to analyze lipid changes and to evaluate the efficacy, safety, tolerability and any self-reported depression, using the Thai Depression Inventory, at 24 weeks. Arial;mso-ansi-language:EN-US;mso-fareast-language:EN-US; mso-bidi-language:EN-US'> (RPV), drug recently approved by the US FDA, is a non-nucleoside reverse transcriptase inhibitor, which has better lipid profiles than efavirenz (EFV) in treatment naïve patients. However the data on treatment experience is limited especially in dyslipidemic HIV-patients thus we aimed to assess the change of lipid profiles after switching from EFV to RPV in these patients.
Results: Fifty-three patients were enrolled and completed the study. At week 24, a significant decrease in the mean (95% confident interval, CI) total cholesterol (-28.06 mg/dL, 95%CI -35.20 to -20.91, p<0.0001), LDL-cholesterol (-20.96 mg/dL, 95%CI -28.12 to -13.80, p<0.0001), HDL-cholesterol (-5.11 mg/dL, 95%CI -7.79 to -2.44, p<0.0001) and triglyceride (-29.79 mg/dL. 95%CI -52.39 to -7.19, p=0.011) levels were observed. One patient had virologic rebound with HIV RNA of 114 copies/mL at week 24. Three (5.7%) patients had grade 2 elevation of liver enzymes. There was a worsening of depression at week 24 in 2 subjects. None of the patients discontinued RPV during the study.
Conclusion: Switching from EFV-based therapy to RPV-based regimen improved lipid profiles in fully suppressed HIV patients with dyslipidemia. However, the switch should be made with caution, vigilantly monitoring for any adverse neuropsychiatric events.
S. Anunnatsiri, None
P. Mootsikapun, None