Switching to triple NRTI therapy from an NNRTI-based HAART regimen can lead to a significant improvement in lipids without loss of virological control, according to a Europe-wide study published in the August 15th edition of AIDS.
The GlaxoSmithKline TRIZAL study was a randomised, open label study, designed to investigate the safety of switching HAART patients who had achieved an HIV viral load below 50 copies/mL for at least six months to triple NRTI therapy, consisting of Trizivir (AZT, 3TC and abacavir).
Of the 209 patients enrolled in the trial, 40 were taking NNRTI based therapy before randomisation. At week 48 of the study, 65% of the 20 patients who remained on an NNRTI had a viral load below 50 copies/mL compared to 75% of the 20 individuals switched to Trizivir (p=0.49).
There were significant differences between the lipid profiles of the NNRTI and switch patients. By the end of the study, fasting cholesterol had fallen by an average of 1.35mmol/L in the Trizivir patients compared to 0.41mmol/L in the NNRTI arm of the study ((p<0.001). Triglycerides, however did not change significantly in either group.
The investigators conclude, “these data provide the first evidence that switching to Trizivir from NNRTI results in the maintenance of viraemia control and an improvement in total cholesterol. The induction of therapy with an NNRTI followed by a switch to Trizivir may provide a good long-term balance of efficacy and tolerability.”
Further information on this website
Cholesterol - factsheet
Switch to Trizivir after 6 months induction just as effective as multi-class therapy - news story
Avoid Zerit, Trizivir in first-line treatment, new UK guidelines recommend - news story
Major PI-sparing study closes Trizivir arm due to inferiority to efavirenz arms - news story
References
Katlama C et al. Comparison of metabolic abnormalities 48 weeks after switching from highly active antiretroviral therapy containing non-nucleoside reverse transcriptase inhibitor to Trizivir versus continued highly active antiretroviral therapy. AIDS 17: 1855 - 1856, 2003.