Evaluation of the Lipid Concentrations after Switching from Antiretroviral Drug Tenofovir Disoproxil Fumarate/Emtricitabine to Abacavir Sulfate/Lamivudine in Virologically-suppressed Human Immunodeficiency Virus-infected Patients

Intern Med. 2016;55(23):3435-3440. doi: 10.2169/internalmedicine.55.7518. Epub 2016 Dec 1.

Abstract

Objective Recently, tenofovir disoproxil fumatate (TDF)-related side effects, such as renal nephrotoxicity and reduction of bone mineral density, have been reported. Consequently, increased switching from fixed-dose tablet TDF and emtricitabine (TDF/FTC) to abacavir and lamivudine (ABC/3TC) has occurred. Interestingly, while TDF has a lipid-lowering property, one of the ABC-related side effects is hyperlipidemia. Therefore, such switching could cause lipid elevation. To evaluate the change in lipid levels associated with switching from TDF/FTC to ABC/3TC in virologically-suppressed human immunodeficiency virus (HIV)-infected patients. Methods This is a retrospective, single-center study. We included the HIV-infected patients whose therapy included a drug switch from TDF/FTC to ABC/3TC between September 2009 and December 2012 at Ryukyu University Hospital. The exclusion criteria were HIV-RNA >40 copies/mL on the switching day, and a documented therapy change to a lipid-lowering agent or any other antiretroviral agents within 3 months before or after switching. We compared the low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), and triglyceride (TG) levels before switching to three months after. Results A total of 18 patients met the inclusion criteria. The LDL, HDL, and TC levels significantly increased three months following the switch (p<0.05), with median (interquartile range) values of 17 (7, 32), 6 (2, 13), and 27 (10, 45) mg/dL, respectively. The TG values did not markedly change. Conclusion Switching from TDF/FTC to ABC/3TC resulted in significantly increased LDL, HDL, and TC levels.

MeSH terms

  • Adult
  • Aged
  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / therapeutic use*
  • Dideoxynucleosides / administration & dosage
  • Dideoxynucleosides / adverse effects
  • Dideoxynucleosides / pharmacology
  • Dideoxynucleosides / therapeutic use*
  • Drug Combinations
  • Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination / administration & dosage
  • Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination / adverse effects
  • Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination / pharmacology
  • Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination / therapeutic use*
  • HIV Infections / drug therapy*
  • Humans
  • Lamivudine / administration & dosage
  • Lamivudine / adverse effects
  • Lamivudine / pharmacology
  • Lamivudine / therapeutic use*
  • Lipids / blood*
  • Male
  • Middle Aged
  • Retrospective Studies

Substances

  • Anti-HIV Agents
  • Dideoxynucleosides
  • Drug Combinations
  • Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
  • Lipids
  • abacavir, lamivudine drug combination
  • Lamivudine