European Journal of Medical Research - Deutsche AIDS ...

June 27, 2007 EUROPEAN JOURNAL OF MEDICAL RESEARCH
103
D.60 (Poster)
Lipid profile, cardiovascular risk factors and
metabolic syndrome in a group of Brazilian
outpatients
Silva E. 1 , Bassichetto K.C. 2 , Lewi D.S. 1
1 HIV Treatment & Clinical Research Unit, Federal University
of São Paulo, São Paulo, Brazil, 2 Department of Municipality
Health of the City of São Paulo, São Paulo, Brazil
Objectives: Evaluation of the lipid profile, cardiovascular
risk factors using the Framingham score and the metabolic
syndrome of the people living with HIV/aids that receive or
not antiretroviral therapy attended at the clinics of the Federal
University of São Paulo and in the Ambulatory of the Secretary
of Health of the city of São Paulo.
Methods: During 18 months 319 patients were selected.
Results: We included 243 patients with antiretroviral therapy
and 76 naïve patients. The median age was 39,7 years and
60,9% of the patients were male. The major cardiovascular
risk factors in this population were: 26,8% smoking, 19,2%
hypertension, 4,0% diabetes, 40,2% of familiar history of
aterosclerosis. In the lipid profile the median of the total cholesterol
(205 x 108 mg/dL), HDL-c (51 x 43 mg/dL) and
triglycerides (219 x 164 mg/dL) were higher in the group with
antiretroviral therapy. According to the Framingham equation,
88,6% and 95,9% of the patients in the group 1 and 2 respectively
has a low risk of cardiovascular disease. The metabolic
syndrome was present in 12,6% of the patients with antiretroviral
therapy and in 11,6% (p=0,832) in the naïve
group.
Conclusion: The median of total cholesterol, HDL-c, triglycerides
were higher in the group with antiretroviral therapy.
The cardiovascular risk was low in the two groups according
to the Framingham score. The presence of metabolic syndrome
was analogous in both groups.
D.61 (Vortrag)
Increase of susceptibility to Atazanavir (ATV) and
Saquinavir (SQV) in multidrug-resistant HIV-1
infected patients carrying Protease-Inhibitor (PI)
mutation L76V
Braun P. 1 , Walter H. 2 , Däumer M. 3 , Ehret R. 1 , Korn K. 2 ,
Kaiser R. 3 , Thiele B. 4 , Berg T. 5 , Stürmer M. 6 , Hower M. 7 ,
Knechten H. 1 , Wiesmann F. 1
1 PZB Aachen, Aachen, Germany, 2 Universität Erlangen,
Erlangen, Germany, 3 Universität Köln, Köln, Germany,
4 Institut für Immunologie, Kaiserslautern, Germany, 5 MedLab
Berlin, Berlin, Germany, 6 Universität Frankfurt, Frankfurt,
Germany, 7 ID-Ambulanz Dortmund, Dortmund, Germany
Background: L76V is a rarely observed mutation in clinical
isolates of HIV-1 infected patients (pts) with increasing
prevalence from 0.17%-1.5% (1998-2005). It is selected under
Lopinavir-(LPV), Amprenavir-(APV) and possibly
Darunavir-containing treatment and is associated with strong
resistance against these drugs. It is furthermore discussed to
confer increased susceptibility to ATV and SQV Our objevtive
was to elucidate the clinical implication of the L76V mutation
in the response to PI-containing regimen in pts with
strongly limited therapy options.
Methods: Virological, immunological and genotypical data
of 30 therapy-experienced, HIV-1 multiclass-resistant, L76V-
positive pts were obtained retrospectively. 24 pts were threeclass
resistant and 6 showed NRTI- and PI-resistance. 11 pts
started a new regimen containing boosted ATV and/or SQV
(Group A). 10 pts switched to ATV or SQV plus LPV or APV
to maintain selection pressure on L76V (Group B); and 9 pts
received LPV or APV regimens (Group C). 26 pts received an
optimized backbone therapy, mostly NRTI. Viral-load (VL)
and CD4-counts were determined at baseline, and week 12-
96. Success of therapy was defined as VL-reduction