AIDSWEEKLY Plus; Monday, December 22, 2003
Staff Medical Writers

"New HIV therapies have significantly increased survival, but are associated with multiple metabolic changes, most of them related to the protease inhibitors (PIs)," scientists in Spain noted.

C. Fisac and colleagues at the University Hospital of Bellvitge conducted a study "to elucidate and compare morphological and metabolic alterations in HIV-infected antiretroviral-naive patients receiving two nucleosides plus the PI nelfinavir (NFV) or the nonnucleoside reverse transcriptase inhibitor nevirapine (NVP)."

"Forty-three patients (NFV, n=20; NVP, n=23) receiving 6-12 months of treatment were analyzed," they explained in the Journal of Clinical Endocrinology and Metabolism. "Morphological changes were evaluated by bioelectrical impedance analysis, standard anthropometrics, and clinical examination. Serum total cholesterol (TC), low-density and high-density (HDL-c) lipoprotein cholesterol, triglycerides, glucose, and insulin were determined, among other metabolic parameters."

"No baseline differences were observed between groups," while "TC increased in both arms (NVP, 11%; NFV, 17%)," test results showed. "HDL-c also increased in both groups, although more markedly in those receiving NVP (44% vs. 20%); on-treatment levels were also elevated (1.57 vs. 1.28 mmol/liter)."

"As a consequence of these changes, the TC/HDL-c ratio dropped by 22% in the NVP arm and remained stable in the NFV group," according to the report. "With the use of NFV, the TC/HDL-c ratio and attendant cardiovascular risk did not change. In contrast, NVP offered benefits regarding lipid status, as manifested by enhanced HDL-c concentrations and decreased TC/HDL-c ratios."

"Inclusion of NVP should be considered when deciding upon antiretroviral regimens for patients at high coronary risk," the researchers concluded.

Fisac and coauthors published the results of their research in the Journal of Clinical Endocrinology and Metabolism (A comparison of the effects of nevirapine and nelfinavir on metabolism and body habitus in antiretroviral-naive human immunodeficiency virus-infected patients: A randomized controlled study. J Clin Endocrinol Metab. 2003 Nov;88(11):5186-92.

For additional information, contact C. Fisac, University Hospital of Bellvitge, Endocrinology and Nutrition Service, C. Feixa Llarga s/n, Barcelona 08907, Spain.

The publisher of the Journal of Clinical Endocrinology and Metabolism can be contacted at: Endocrine Society, 4350 East West Highway Suite 500, Bethesda, MD 20814-4110, USA.

The information in this article comes under the major subject areas of AIDS & HIV and Cardiovascular Disease.

This article was prepared by AIDS Weekly editors from staff and other reports.

Reference

Fisac C, Virgili N, Ferrer E, et al., "A comparison of the effects of nevirapine and nelfinavir on metabolism and body habitus in antiretroviral-naive human immunodeficiency virus-infected patients: a randomized controlled study", J Clin Endocrinol Metab. 2003 Nov;88(11):5186-92.

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