Incidence of dyslipidemia in people with HIV who are treated with integrase inhibitors versus other antiretroviral agents

Byonanebye, D. M.; Polizzotto, M. N.; Begovac, J.; Grabmeier-Pfistershammer, K.; Abela, I.; Castagna, A.; de Wit, S.; Mussini, C.; Vehreschild, J. J.; d'Arminio Monforte, A.; Wit, F. W. N. M.; Pradier, C.; Chkhartishvili, N.; Sonnerborg, A.; Hoy, J.; Lundgren, J.; Neesgaard, B.; Bansi-Matharu, L.; Greenberg, L.; Llibre, J. M.; Vannappagari, V.; Gallant, J.; Necsoi, C.; Cichon, P.; Reiss, P.; Aho, I.; Tsertsvadze, T.; Mennozzi, M.; Rauch, A.; Muccini, C.; Law, M.; Mocroft, A.; Ryom, L.; Petoumenos, K.; Hillebregt, M.; Rose, N.; Zangerle, R.; Appoyer, H.; Delforge, M.; Wandeler, G.; Stephan, C.; Bucht, M.; Chokoshvili, O.; Rodano, A.; Tavelli, A.; Fanti, I.; Borghi, V.; Fontas, E.; Dollet, K.; Caissotti, C.; Casabona, J.; Miro, J. M.; Smith, C.; Lampe, F.; Johnson, M.; Burns, F.; Chaloner, C.; Lazzarin, A.; Poli, A.; Falconer, K.; Svedhem, V.; Gunthard, H.; Ledergerber, B.; Bucher, H.; Scherrer, A.; Wasmuth, J. C.; Rockstroh, J.; Fatkenheuer, G.; Stecher, M.; Schulze, N.; Franke, B.; Rooney, J.; Rogatto, F.; Garges, H.; Kowalska, J.; Raben, D.; Peters, L.; Anne, A. V.; Dedes, N.; Williams, E. D.; Bruguera, A.; Haubrich, R.; Svedhem-Johansson, V.; Bloch, M.; Braun, D.; Calmy, A.; Schuttfort, G.; Youle, M.; Zona, S.; Antinori, A.; Bolokadze, N.; Schwarze-Zander, C.; Duvivier, C.; Dragovic, G.; Radoi, R.; Oprea, C.; Vasylyev, M.; Matulionyte, R.; Mulabdic, V.; Marchetti, G.; Kuzovatova, E.; Coppola, N.; Martini, S.; Harxhi, A.; Waehre, T.; Pharris, A.; Vassilenko, A.; Bogner, J.; Maagaard, A.; Jablonowska, E.; Elbirt, D.; Marrone, G.; Leen, C.; Wyen, C.; Kundro, M.; Gallant, J.; Thorpe, D.; Volny-Anne, A.; Mendao, L.; Larsen, J. F.; Jakobsen, M. L.; Bruun, T.; Bojesen, A.; Hansen, E. V.; Elsing, T. W.; Kristensen, D.; Thomsen, S.; Weide, T.; Pelchen-Matthews, A.

doi:10.1097/QAD.0000000000002811

Objective: To compare the incidence of dyslipidemia in people with HIV receiving integrase inhibitors (INSTI) versus boosted protease inhibitors (PI/b) and nonnucleoside reverse transcriptase inhibitors (NNRTI) within RESPOND consortium of prospective cohorts. Methods: Participants were eligible if they were at least 18 years, without dyslipidemia and initiated or switched to a three-drug antiretroviral therapy (ART)-regimen consisting of either INSTI, NNRTI, or PI/b for the first time, between 1 January 2012 and 31 December 2018. Dyslipidemia was defined as random total cholesterol more than 240 mg/dl, HDL less than 35 mg/dl, triglyceride more than 200 mg/dl, or initiation of lipid-lowering therapy. Poisson regression was used to determine the adjusted incidence rate ratios. Follow-up was censored after 3 years or upon ART-regimen discontinuation or last lipid measurement or 31 December 2019, whichever occurred first. Results: Overall, 4577 people with HIV were eligible (INSTI = 66.9%, PI/b = 12.5%, and NNRTI = 20.6%), 1938 (42.3%) of whom were ART-naive. During 1.7 (interquartile range, 0.6 - 3.0) median years of follow-up, 1460 participants developed dyslipidemia [incidence rate: 191.6 per 1000 person-years, 95% confidence interval (CI) 182.0 - 201.7]. Participants taking INSTI had a lower incidence of dyslipidemia compared with those on PI/b (adjusted incidence rate ratio 0.71; CI 0.59 - 0.85), but higher rate compared with those on NNRTI (1.35; CI 1.15 - 1.58). Compared with dolutegravir, the incidence of dyslipidemia was higher with elvitegravir/cobicistat (1.20; CI 1.00 - 1.43) and raltegravir (1.24; CI 1.02 - 1.51), but lower with rilpivirine (0.77; CI 0.63 - 0.94). Conclusion: In this large consortium of heterogeneous cohorts, dyslipidemia was less common with INSTI than with PI/b. Compared with dolutegravir, dyslipidemia was more common with elvitegravir/cobicistat and raltegravir, but less common with rilpivirine.

Incidence of dyslipidemia in people with HIV who are treated with integrase inhibitors versus other antiretroviral agents / Byonanebye, D. M.; Polizzotto, M. N.; Begovac, J.; Grabmeier-Pfistershammer, K.; Abela, I.; Castagna, A.; de Wit, S.; Mussini, C.; Vehreschild, J. J.; d'Arminio Monforte, A.; Wit, F. W. N. M.; Pradier, C.; Chkhartishvili, N.; Sonnerborg, A.; Hoy, J.; Lundgren, J.; Neesgaard, B.; Bansi-Matharu, L.; Greenberg, L.; Llibre, J. M.; Vannappagari, V.; Gallant, J.; Necsoi, C.; Cichon, P.; Reiss, P.; Aho, I.; Tsertsvadze, T.; Mennozzi, M.; Rauch, A.; Muccini, C.; Law, M.; Mocroft, A.; Ryom, L.; Petoumenos, K.; Hillebregt, M.; Rose, N.; Zangerle, R.; Appoyer, H.; Delforge, M.; Wandeler, G.; Stephan, C.; Bucht, M.; Chokoshvili, O.; Rodano, A.; Tavelli, A.; Fanti, I.; Borghi, V.; Fontas, E.; Dollet, K.; Caissotti, C.; Casabona, J.; Miro, J. M.; Smith, C.; Lampe, F.; Johnson, M.; Burns, F.; Chaloner, C.; Lazzarin, A.; Poli, A.; Falconer, K.; Svedhem, V.; Gunthard, H.; Ledergerber, B.; Bucher, H.; Scherrer, A.; Wasmuth, J. C.; Rockstroh, J.; Fatkenheuer, G.; Stecher, M.; Schulze, N.; Franke, B.; Rooney, J.; Rogatto, F.; Garges, H.; Kowalska, J.; Raben, D.; Peters, L.; Anne, A. V.; Dedes, N.; Williams, E. D.; Bruguera, A.; Haubrich, R.; Svedhem-Johansson, V.; Bloch, M.; Braun, D.; Calmy, A.; Schuttfort, G.; Youle, M.; Zona, S.; Antinori, A.; Bolokadze, N.; Schwarze-Zander, C.; Duvivier, C.; Dragovic, G.; Radoi, R.; Oprea, C.; Vasylyev, M.; Matulionyte, R.; Mulabdic, V.; Marchetti, G.; Kuzovatova, E.; Coppola, N.; Martini, S.; Harxhi, A.; Waehre, T.; Pharris, A.; Vassilenko, A.; Bogner, J.; Maagaard, A.; Jablonowska, E.; Elbirt, D.; Marrone, G.; Leen, C.; Wyen, C.; Kundro, M.; Gallant, J.; Thorpe, D.; Volny-Anne, A.; Mendao, L.; Larsen, J. F.; Jakobsen, M. L.; Bruun, T.; Bojesen, A.; Hansen, E. V.; Elsing, T. W.; Kristensen, D.; Thomsen, S.; Weide, T.; Pelchen-Matthews, A.. - In: AIDS. - ISSN 0269-9370. - 35:6(2021), pp. 869-882. [10.1097/QAD.0000000000002811]