Impact of antiretroviral therapy interruption on plasma biomarkers of cardiovascular risk and lipids: 144-week final data from the STOPAR study
Por:
Olmo, M, Saumoy, M, Alonso-Villaverde, C, Penaranda, M, Gutierrez, F, Romeu, J, Larrousse, M, Curto, J, Domingo, P, Oteo, JA, Vila, A, Podzamczer, D
Publicada:
1 sep 2012
Resumen:
Objective The aim of the study was to investigate changes in plasma biomarkers of cardiovascular risk and lipids in a CD4-guided antiretroviral therapy interruption study. Methods This was a substudy of a prospective, randomized, multicentre treatment interruption study. At months 12, 24 and 36, monocyte chemotactic protein-1 (MCP-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), interleukin-6 (IL-6), interleukin-8 (IL-8), soluble CD40 ligand (sCD40L), soluble P-selectin (sP-selectin), and tissue plasminogen activator (t-PA) were measured using a multiplex cytometric bead-based assay. Total cholesterol (total-c), high-density lipoprotein cholesterol (HDL-c) and triglycerides (TG) were determined using standard methods. Results Fifty-four patients were included in the study [34 in the treatment continuation (TC) arm and 20 in the treatment interruption (TI) arm]. There were no differences at baseline between the groups, except in CD4 cell count, which was higher in the TI arm (P?=?0.026), and MCP-1, which was higher in the TC arm (P?=?0.039). MCP-1 and sVCAM-1 were increased relative to baseline at the three study time-points in the TI arm, with no changes in the TC arm. Soluble CD40L and sP-selectin were increased at month 36 in both arms, with a greater increase in the TI arm (P?=?0.02). t-PA was increased in both arms at the three time-points. Total-c, HDL-c and low-density lipoprotein cholesterol (LDL-c) were decreased in the TI arm at the three time-points, with no changes in the total-c/HDL-c ratio. HIV viral load positively correlated with MCP-1 at months 12 and 24. Regression analysis showed a significant negative association of HDL-c with MCP-1 and sVCAM-1. Conclusions A significant increase in cardiovascular risk biomarkers persisting over the prolonged study period was seen in the TI arm. This factor may contribute to the increased cardiovascular risk observed in previous studies.
Filiaciones:
Olmo, M:
Hosp Univ Bellvitge, Infect Dis Serv, Bellvitge Biomed Res Inst IDIBELL, Barcelona 08907, Spain
Saumoy, M:
Hosp Univ Bellvitge, Infect Dis Serv, Bellvitge Biomed Res Inst IDIBELL, Barcelona 08907, Spain
Alonso-Villaverde, C:
Hosp Son Llatzer, Internal Med Serv, Mallorca, Spain
Penaranda, M:
Hosp Son Llatzer, Internal Med Serv, Mallorca, Spain
Gutierrez, F:
Univ Miguel Hernandez, Hosp Gen dElx, Infect Dis Serv, Alicante, Spain
Romeu, J:
Univ Hosp Germans Trias & Pujol, Fight AIDS Fdn, Badalona, Spain
Larrousse, M:
Hosp Clin Barcelona, Infect Dis Serv, Barcelona, Spain
Curto, J:
Hosp Univ Bellvitge, Infect Dis Serv, Bellvitge Biomed Res Inst IDIBELL, Barcelona 08907, Spain
Domingo, P:
Hosp San Pau & Santa Creu, Internal Med Serv, Barcelona, Spain
Oteo, JA:
Hosp Rioja, Infect Dis Serv, Logrono, Spain
Vila, A:
Hosp Univ Bellvitge, Infect Dis Serv, Bellvitge Biomed Res Inst IDIBELL, Barcelona 08907, Spain
Podzamczer, D:
Hosp Univ Bellvitge, Infect Dis Serv, Bellvitge Biomed Res Inst IDIBELL, Barcelona 08907, Spain
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