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Efavirenz treatment increases HDL-cholesterol
  NEW YORK (Reuters Health) - Treatment of HIV with efavirenz, either in antiretroviral-naive patients or as a replacement for a protease inhibitor (PI), improves patients' HDL-cholesterol levels and their LDL/HDL index, investigators in Spain report.
Another non-nucleoside transcriptase reverse inhibitor (NNRTI), nevirapine, enhances the lipoprotein profile when substituted for a PI. To see if the same is true for efavirenz, Dr. Eugenia Negredo and associates followed 20 HIV-infected patients for 48 weeks after initiating treatment with efavirenz. Ten patients were switched from a PI and the other 10 were starting antiretroviral treatment for the first time.
Mean HDL levels increased from 38.5 to 52.6 mg/dL (p < 0.0001) in the treatment naïve group, and from 41.8 to 48.0 mg/dL in those previously treated with a PI (p = 0.005).
Efavirenz was associated with "a strikingly significant reduction of the LDL/HDL cholesterol ratio from 3.34 to 2.91 (p = 0.028)," Dr. Negredo, at Germans Trias i Pujol University Hospital in Barcelona, and associates write in a research letter published in the March 26th issue of AIDS. These changes were independent of triglyceride levels.
Because PIs may adversely affect lipid profiles, "switching PI to NNRTI could be of interest to treat hyperlipidemia in this population," the authors conclude.


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