Effects of first antiretroviral regimen on lipid levels in HIV (z) individuals A. Papadopoulos 1 , N. Pantazis 2 , P. Panagopoulos 1 , S. Kourkounti 3 , G. Xylomenos 4 , M. Chini 5 , G. Petrikkos 6 , H. Sambatakou 7 , P. Ioannidou 8 , T. Kordosis 9 , G. Panos 1 , G. Touloumi 2 1 Fourth Department of Internal Medicine, Athens Medical School, ‘Attikon’ University General Hospital, 2 Department of Hygiene, Epidemiology & Medical Statistics, Athens University Medical School, 3 AIDS Unit, Clinic of Venereologic & Dermatologic Diseases, Athens Medical School, ‘Syngros’ Hospital, 4 Fourth Department of Internal Medicine, Athens Medical School, ‘G. Gennimatas’ Athens General Hospital, 5 Third Department of Internal Medicine & Infectious Diseases Unit, ‘Korgialenio-Benakio Hellenic Red Cross’ Athens General Hospital, 6 Infectious Diseases Research Laboratory, First Department of Propedeutic Medicine, ‘Laikon’ Athens General Hospital, 7 HIV Unit, Second Department of Internal Medicine, Athens Medical School, ‘Hippokration’ University General Hospital, 8 Haemophilia Centre, Second Blood Transfusion Centre, ‘Laikon’ Athens General Hospital, 9 Medical Oncology Unit, Department of Pathophysiology, ‘Laikon’ Athens General Hospital, 10 HIV Unit, Second Internal Medicine Clinic, First IKA, Athens, Greece Objective: To evaluate the long-term effects of different boosted protease inhibitors (bPIs) or non- nucleoside reverse transcriptase inhibitors (NNRTIs)-based antiretroviral regimens on lipid levels in HIV seropositive individuals who have not received lipid-lowering agents. Methods: Data consisted of 595 patients participating in the population-based Athens Multicenter Cohort Study who were consistently followed up during 1996–2008. Results: In naı ¨ve patients, lipid parameters increased sharply during the first 3 months of antiretroviral therapy and reached a plateau level approximately 6–9 months after therapy initiation. The plateau levels remained almost stable for up to 3.5 years. In general, bPIs exerted a more pronounced effect compared to NNRTIs. Conclusions: The administration of PI- or NNRTI-based regimens especially in naı ¨ve but also in unboosted PI experienced patients provoked a sharp increase in lipid levels that remained stable in higher levels for more than 3 years. Keywords: HIV, Antiretrovirals, Lipid levels Introduction Among the most common complications of highly active antiretroviral treatment (HAART) are dyslipi- daemia and metabolic syndrome, the latter defined as the combination of glucose intolerance, blood hyper- tension, lipodystrophy, and elevation in blood choles- terol and triglycerides levels. 1 The contribution of HAART to dyslipidaemia as well as to myocardial infarction continues to be a subject of intensive investigation. 2,3 In addition, differences exist among the protease inhibitors (PIs) concerning their effect on lipid levels, whereas the Smart Study denoted the decrease in both the high density lipoprotein (HDL) levels and the atheromatic ratio (total cholesterol/HDL) in the group of patients who interrupted HAART. 4 The time at which the highest serum lipids levels are achieved is largely unknown, whereas the introduction of newer antiretroviral drugs has provided greater degree of HIV suppression with fewer metabolic effects. This study was designed to estimate the effects of different antiretroviral regimens on lipids in HIV seropositive individuals, either antiretroviral therapy- naı ¨ve or experienced with regimens including mainly unboosted PIs. Materials and Methods Data were derived from the Greek Multicenter Study AMACS (Athens Multicenter Cohort Study). AMACS is an open, ongoing, population-based cohort study of HIV (z) individuals initiated in 1996. Collaborative sites include the nine largest HIV-1 clinics located in Athens, Greece. All study participants had signed the informed consent document for the anonymous use of Correspondence to: P Panagopoulos, Fourth University Department of Internal Medicine, Attikon University General Hospital, First Rimini Street, Haidari, 12462 Athens, Greece. Email: ppanag@med.uoa.gr 38 ß 2012 Edizioni Scientifiche per l’Informazione su Farmaci e Terapia DOI 10.1179/1120009X12Z.0000000008 Journal of Chemotherapy 2012 VOL. 24 NO.1