Impact of switching from lopinavir/ritonavir to boosted and un-boosted atazanavir on glucose metabolism: the ATAzanavir & GLUcose metabolism (ATAGLU) study

Gabriella d’Ettorre, Giancarlo Ceccarelli, Mauro Zaccarelli, Tommaso Ascoli-Bartoli, Luigi Bianchi, Valeria Bellelli, Gabriella De Girolamo, Sara Serafino, Noemi Giustini, Claudio M. Mastroianni, Vincenzo Vullo

Research output: Contribution to journalArticle

Abstract

Previous studies have reported that protease inhibitors (PIs) can contribute to glycaemic alterations. However, there are few trials examining the direct effect of a single PI. The objective of the study was to evaluate the modifications of glucose and lipid profiles after a switch from lopinavir/ritonavir (LPV/r) to atazanavir, used as ritonavir-boosted (ATV/r) or un-boosted. We conducted a retrospective observational cohort study on the effect of ATV/(r) on glycaemic metabolism (ATAGLU) in patients with undetectable levels of HIV-RNA who switched from LPV/r. In total, 235 patients treated for 48 weeks with LPV/r plus two nucleoside reverse transcriptase inhibitors (NRTIs) and with undetectable HIV-RNA were included: 134 continued LPV/r after the initial 48 weeks and 101 switched to ATV(/r) (18.3% to ATV; 24.7% to ATV/r). A significant decrease in mean glucose level and insulin resistance was observed in patients who switched to ATV(/r). The mean cholesterol triglyceride levels increased in the LPV/r group and decreased among the patients who switched. A significant increase of CD4 T cells with undetectable levels of HIV-RNA was observed in all groups. The long-term results obtained in this real-life study suggest that patients who have achieved initial suppression on a regimen including LPV/r + two NRTIs can switch to ATV/(r) + two NRTIs with an improvement in lipid and glycaemic metabolism.

Original languageEnglish
Pages (from-to)638-643
Number of pages6
JournalInternational Journal of STD and AIDS
Volume27
Issue number8
DOIs
Publication statusPublished - Jul 1 2016

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Keywords

  • AIDS
  • antiretroviral therapy
  • atazanavir
  • cardiovascular risk
  • glucose
  • glycaemic metabolism
  • HIV
  • insulin resistance
  • lopinavir
  • protease inhibitor
  • ritonavir
  • switch study
  • treatment

ASJC Scopus subject areas

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

d’Ettorre, G., Ceccarelli, G., Zaccarelli, M., Ascoli-Bartoli, T., Bianchi, L., Bellelli, V., De Girolamo, G., Serafino, S., Giustini, N., Mastroianni, C. M., & Vullo, V. (2016). Impact of switching from lopinavir/ritonavir to boosted and un-boosted atazanavir on glucose metabolism: the ATAzanavir & GLUcose metabolism (ATAGLU) study. International Journal of STD and AIDS, 27(8), 638-643. https://doi.org/10.1177/0956462415590724