| Title | Plasma lipid profile in pregnant women with HIV receiving nevirapine. | | Author(s) | Floridia M, Tamburrini E, Anzidei G, Tibaldi C, Guaraldi G, Guerra B, Meloni AM, Vimercati A, Molinari A, Pinnetti C, Dalzero S, Ravizza M, Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy | | Institution | Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanita, Viale Regina Elena 299, 00161 Rome, Italy. marco.floridia@iss.it | | Source | AIDS Patient Care STDS 2009 Mar; 23(3):147-52. | | MeSH | Adolescent
Adult
Anti-HIV Agents
Cholesterol
Drug Therapy, Combination
Female
HIV Infections
HIV-Associated Lipodystrophy Syndrome
Humans
Hyperlipidemias
Lipids
Nevirapine
Pregnancy
Pregnancy Complications, Infectious
Reverse Transcriptase Inhibitors
Triglycerides
Young Adult
| | Abstract | Limited information is currently available on the metabolic profile of nevirapine in pregnancy. We used data from a national observational study to evaluate plasma lipid profile in pregnant women receiving nevirapine. Lipid values were collected during routine clinical visits. Midpregnancy (second trimester) lipid values were analyzed according to use of nevirapine, calculating differences and 95% confidence intervals (CI) between women taking and not taking this drug. In order to adjust for possible confounders, multivariable models were constructed using as dependent variables levels of total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), triglyceride (TG) levels and TC/HDL-C ratio, and as independent variables age, body weight, previous treatment history, CD4 count, and presence of any antiretroviral therapy, use or nonuse of protease inhibitors, stavudine, and nevirapine at the time of blood sampling. Overall, 375 women had available data for analysis. Pregnant women on nevirapine, compared to women not taking this drug, had in univariate analyses higher levels of HDL-C (difference: +13.0mg/dL [95%CI 7.4-18.6], p < 0.001), lower values of TC/HDL-C ratio (difference: -0.51 [0.23-0.80], p < 0.001) and a trend for lower levels of triglycerides (difference: -17.6mg/dL [0.7-35.9], p = 0.06). Higher HDL-C levels were also associated with use of protease inhibitors and with no previous antiretroviral experience before pregnancy. The associations with higher HDL-C levels were confirmed in multivariable analyses. Our study indicates in pregnant women an association between nevirapine use and higher HDL-C levels. Further studies should assess whether this effect is due to an intrinsic activity of nevirapine and define the potential mechanisms involved. | | Language | eng | | Pub Type(s) | Journal Article
Research Support, Non-U.S. Gov't
| | PubMed ID | 19866532 |
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