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Drug Substitution Improves Dyslipidemia in HIV Patients

Substitution of tenofovir for stavudine results in significantly improved lipid levels

THURSDAY, July 13 (HealthDay News) -- In HIV-positive patients receiving highly active antiretroviral therapy (HAART), the substitution of tenofovir for stavudine results in a modest yet robust and sustained improvement in dyslipidemia, according to a study published in the June 26 issue of AIDS.

Josep M. Llibre, M.D., of Hospital de Calella in Barcelona, Spain, and colleagues studied lipid profiles in 352 HIV patients who were switched from stavudine to tenofovir.

At 48 weeks, the researchers observed sustained mean reductions in median total cholesterol (-17.5 mg/dL), low-density lipoprotein cholesterol (-8.1 mg/dL) and triglycerides (-35 mg/dL), and little change in high-density lipoprotein cholesterol (-0.8 mg/dL). They also found that patients with baseline hyperlipidemia showed greater reductions in LDL-C (-29 mg/dL) and triglycerides (-76 mg/dL). They observed the greatest mean triglyceride reduction (-266 mg/dL) in patients with baseline levels above 500 mg/dL.

"The first large-scale prospective substitution study from stavudine to tenofovir unveils that this replacement may reverse, at least partially, lipid abnormalities and reduces the cardiovascular disease risk and the atherogenic profile in HIV-1-treated patients," the authors conclude. "This safe switch strategy could reduce the use of hypolipidemic drugs and the rate of severe hypertriglyceridemia and must be considered as another possible approach to the treatment of dyslipidemia associated with HIV-infection and HAART."

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