Efavirenz to Nevirapine Switch in HIV-1–Infected Patients with Dyslipidemia: A Randomized, Controlled Study

Epidemiologie, Systemes d'Informations, Modelisation, Institut National de la Sante et de la Recherche Medicale U707, Paris, France.
Clinical Infectious Diseases (Impact Factor: 9.42). 08/2007; 45(2):263-6. DOI: 10.1086/518973
Source: PubMed

ABSTRACT Many antiretroviral therapies, including efavirenz, are associated with increased serum concentrations of low-density lipoprotein cholesterol. In a small 52-week randomized study, we found that switching from efavirenz to nevirapine was associated with significantly decreased low-density lipoprotein cholesterol levels, compared with continuation of efavirenz therapy (P < .04). A switch to nevirapine was associated with no severe adverse events. © 2007 by the Infectious Diseases Society of America. All rights reserved.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Three dimensional (3-D) quantum mechanical models of ion movements in a cylindrical ion-channel, based on a steady state Schrodinger equation in a single particle system and in a time independent field, ore improved in this study. The improved models elucidate that: ions, going through a cylindrical channel, travel in the longitudinal (x) direction and wave as well as are free and trapped in an infinite deep potential energy web in the transversal (r and θ) directions. A quantum mechanical model of a single channel current can be derived from the model of ions' movements in the longitudinal (x) direction. Experimental data of a single channel current can be parameterly fitted well with the model. The ions' radical waves obey Bessel functions of the first kind of order I with a parameter k<sub>n</sub> and it has a solution: R(r)=B J<sub>1</sub> (r k<sub>n</sub>), where a is a constant, n=1, 2, 3, ..., and 0, 1, 2, 3, ... . The highest probability that an ion con be found In a cross section within a cylindrical ion-channel is on or close to the longitudinal axis according to the principle of the minimum energy state. The ions' angular waves are: Θ(θ)=c <sub>1</sub> exp(110)-c<sub>2</sub> exp(-110), where, c<sub>1</sub> and c<sub>2</sub> are constants, and l=0, 1, 2, 3 ... . These results are consistent with the previous results obtained from 3-D quantum mechanical models of ion movements in a cuboidal ion-channel and those macroscopic descriptions represented with classic theory of fluid dynamics
    Biomedical Engineering Conference, 1997., Proceedings of the 1997 Sixteenth Southern; 05/1997
  • Future HIV Therapy 01/2008; 2(1):83-92. DOI:10.2217/17469600.2.1.83
  • [Show abstract] [Hide abstract]
    ABSTRACT: The objective of present research is to evaluate the lipid lowering efficacy and safety of switching within non-nucleoside reverse transcriptase inhibitors (NNRTI) in HIV-infected patients.This is a multicenter, retrospective study utilizing a comprehensive electronic patient registry to identify all adult HIV-infected patients seen from October 1, 1998 through October 1, 2006, whosubstituted efavirenz for nevirapine (EFV®NVP) or vice-versa (NVP®EFV), without change in other antiretrovirals. Lipid profiles before and after the switch were analyzed. A total of 124 patients were identified with 14 male (EFV®NVP, n = 9; NVP®EFV, n = 5) patients meeting the strict criteria for inclusion. An EFV®NVP switch resulted in significant reductions in TC -16% and non-HDL -25%(p£0.02) and a trend towards a reduction in LDL-C -12%, TG -27%, TC/HDL -23%, TG/HDL -48% and an increase in HDL-C +15% without any changes to BMI, viral or immunological control. However, a NVP®EFV switch appeared to result in a non-significant worsening of LDL-C +29%, HDL-C -8%, TG +36%, non-HDL +28%, TC/HDL +57% and TG/HDL +46%. Lastly, more patients achieved their lipid goals when switched from EFV to NVP. These data suggest that switching from EFV to NVP-based HAART is associated with lipid improvement, however, switching from NVP to EFV-based HAART is associated with worsening of serum lipids.
    American journal of infectious diseases 02/2008; DOI:10.3844/ajidsp.2008.147.151
Show more