Use of metabolic drugs and fish oil in HIV-positive patients with metabolic complications and associations with dyslipidemia and treatment targets

2007 | HIV Medicine

Program(s): Clinical Programs |
Initiative(s): Drug Treatment Program |

http://www.ncbi.nlm.nih.gov/pubmed/17661842

Abstract:

BACKGROUND: Highly active antiretroviral therapy (HAART) with protease inhibitors (PI) is successful in suppressing viral replication, but may lead to a range of metabolic abnormalities associated with cardiovascular disease (CVD). OBJECTIVES: The first objective of the study was to compare baseline demographic and clinical characteristics between PI users and non-PI users referred to a specialized metabolic clinic during 1999-2003. The second objective was to assess the associations of prescription drugs and fish oil with dyslipidaemia and to determine whether or not patients achieved treatment targets during 6 months of treatment. METHODS: A retrospective analysis was performed using two sets of charts based on standardized forms with entries for personal data, drug treatment and clinical history. Anonymous linkage with the British Columbia HIV/AIDS Drug Treatment Program and the hospital laboratory was performed to gather information about HAART prescriptions and blood work. RESULTS: In total, 237 patients were included in the study. There were few differences in any demographic or clinical factors between PI users and non-PI users. Compared with controls not taking lipid-lowering drugs or fish oil (n=48), statins appeared to be the only agent that was significantly associated with a reduced total cholesterol concentration (-15.6%; P=0.009). Fibrate treatment was associated with the largest reduction of triglyceride concentration (-37.4%; P=0.012), closely followed by fish oil (n=18;-32%; P=0.027). Six-month treatment success rates ranged between 17 and 43% of patients for total cholesterol (<5.2 mmol/L) and between 15 and 44% of patients for triglycerides (<2.3 mmol/L). CONCLUSIONS: Despite the apparent lowering of blood lipids with drug and fish oil treatments, a majority of patients in these treatment groups (56.5-83.3%) still had elevated concentrations after 6 months.

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Normén L

BC Centre for Excellence in HIV/AIDS

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Use of metabolic drugs and fish oil in HIV-positive patients with metabolic complications and associations with dyslipidemia and treatment targets

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