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Switching HIV Treatments Found to Lower Lipid Levels

But raltegravir less effective than lopinavir-ritonavir at reducing viral levels

WEDNESDAY, Jan. 13 (HealthDay News) -- HIV-infected patients who switch from lopinavir-ritonavir-based therapy to raltegravir have large reductions in lipid levels but less effective virological control, according to a study published online Jan. 13 in The Lancet.

Noting that lopinavir-ritonavir treatment can lead to lipid abnormalities, Joseph J. Eron, M.D., from the University of North Carolina School of Medicine in Chapel Hill, and colleagues randomly assigned 707 HIV-infected patients with stable viral suppression on lopinavir-ritonavir-based therapy to either continue treatment or switch to raltegravir.

At 12 weeks, the researchers found that the raltegravir group had significantly larger reductions in total cholesterol, non-high-density lipoprotein cholesterol, and triglycerides compared with the lopinavir-ritonavir group. However, at 24 weeks, raltegravir was less effective at reducing viral RNA concentrations to less than 50 copies per mL (84.4 versus 90.6 percent). No serious drug-related adverse events or deaths occurred. Because of the lower virological efficacy of raltegravir, the trial was terminated at week 24.

"Although switching to raltegravir was associated with greater reductions in serum lipid concentrations than was continuation of lopinavir-ritonavir, efficacy results did not establish non-inferiority of raltegravir to lopinavir-ritonavir," Eron and colleagues conclude.

The study was funded by Merck. Many of the authors reported financial, consulting, or advisory relationships with pharmaceutical companies, and several authors are employees of Merck.

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