학술논문
Lipids and Transaminase in Antiretroviral-Treatment-Experienced People Living with HIV, Switching to a Doravirine-Based vs. a Rilpivirine-Based Regimen: Data from a Real-Life Setting.
Document Type
Article
Author
Maggi, Paolo; Ricci, Elena Delfina; Martinelli, Canio Vito; De Socio, Giuseppe Vittorio; Squillace, Nicola; Molteni, Chiara; Masiello, Addolorata; Orofino, Giancarlo; Menzaghi, Barbara; Bellagamba, Rita; Vichi, Francesca; Celesia, Benedetto Maurizio; Madeddu, Giordano; Pellicanò, Giovanni Francesco; Carleo, Maria Aurora; Cascio, Antonio; Parisini, Andrea; Taramasso, Lucia; Valsecchi, Laura; Calza, Leonardo
Source
Subject
*HIV-positive persons
*ALANINE aminotransferase
*NON-nucleoside reverse transcriptase inhibitors
*LIPIDS
*ANTIRETROVIRAL agents
*VIRAL load
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Language
ISSN
1999-4915
Abstract
Doravirine (DOR) is a newly approved non-nucleoside reverse transcriptase inhibitor (NNRTI). We aimed to investigate, in a real-life setting, how switching to a DOR-based regimen rather than a rilpivirine (RPV)-based regimen impacted metabolic and hepatic safety. The analysis included 551 antiretroviral treatment (ART)-experienced people living with HIV (PLWH), starting RPV-based or DOR-based regimens with viral load < 200 copies/mL, baseline (T0), and at least one control visit (6-month visit, T1). We enrolled 295 PLWH in the RPV and 256 in the DOR cohort. At T1, total cholesterol (TC), low-density lipoprotein-C (LDL-C), and triglycerides significantly decreased in both DOR and RPV cohorts, while high-density lipoprotein-C (HDL-C) only decreased in RPV-treated people. Consistently, the TC/HDL-C ratio declined more markedly in the DOR (−0.36, p < 0.0001) than in the RPV cohort (−0.08, p = 0.25) (comparison p = 0.39). Similar trends were observed when excluding the PLWH on lipid-lowering treatment from the analysis. People with normal alanine aminotransferase (ALT) levels showed a slight ALT increase in both cohorts, and those with baseline ALT > 40 IU/L experienced a significant decline (−14 IU/L, p = 0.008) only in the DOR cohort. Lipid profile improved in both cohorts, and there was a significant reduction in ALT in PLWH with higher-than-normal baseline levels on DOR-based ART. [ABSTRACT FROM AUTHOR]