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General and Risk Management, Patient Safety (including: medication errors, quality control)
Antiretroviral therapy impact on cardiovascular risk and lipid profile HIV-infected patients
  1. B. Eguileor,
  2. I. Javier,
  3. A. Escudero,
  4. G.I. Ballesteros,
  5. E. Ramió,
  6. J. Delàs,
  7. N. El Hilali,
  8. M. Aguas
  1. 1Capio Hospital sagrat cor, Pharmacy, Barcelona, Spain
  2. 2Capio Hospital sagrat cor, Medicine, Barcelona, Spain

Abstract

Background Antiretroviral therapy (ART), especially the ones based on boosted protease inhibitors (PI/r) may induce dyslipidaemia and therefore increase cardiovascular risk (CVR) on HIV-infected patients. Some studies suggest that Tenofovir (TDF) could be a protective factor.

Purpose To describe the CVR score in HIV-infected patients and identify which kind of ART (PI/r or TDF) is more convenient for lipid profile (LP).

Materials and methods Descriptive cross-sectional study on HIV-patients in a 300 bed hospital during July 2011. Overall 10-years probability for cardiovascular events was evaluated by the Framingham risk score. The authors analysed CVR and LP according to gender, body mass index (BMI), ART-naives and ATR based on PI/r or TDF. Patients were classified as having low, moderate, or high CVR (<10%, 10%–20% and <20%, respectively). Statistical analysis was performed with SPSS.

Results The authors enrolled 47 HIV-infected patients. Values were: median age 48.3±9.8 years, 70.2% male, 30.4% current smokers, mean BMI 23.6±3.3 kg/m2, 23.4% ART-naives, 29.8% on PI/r and 61.7% on TDF. The mean 10-years probability for cardiovascular events was 7.1±6.9%. Patient's prevalence with low, moderate and high CVR was 82.2%, 11.1% and 6.7% respectively. CVR was 8.1% in males compared to 4.7% in women. 4.7% in ART-naïve patients compared to 7.8% in ART-treated patients. 5.6% in BMI<25 kg/m2 patients compared to 10.8% in BMI>25 kg/m2 patients. ART based on TDF had lower CVR than the based on PI/r (5.9% vs 7.8%). ART based on TDF presented lower total cholesterol values than patients treated without TDF (183.4 mg/dl vs 203.2 mg/dl). The opposite was observed with PI/r (196.6 mg/dl vs 188.6 mg/dl). HDL was higher in TDF-ART patients (0.53 mg/dl vs 0.48 mg/dl) and lower in IP/r-ART patients (0.44 mg/dl vs 0.54 mg/dl).

Conclusions The results show that our HIV-patients have better CVR compared to the studies reported in the literature. An ART regime change in patients with bad LP should be considered.

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