Effects of switching from efavirenz to raltegravir on endothelial function, bone mineral metabolism, inflammation, and renal function: a randomized, controlled trial

J Acquir Immune Defic Syndr. 2013 Nov 1;64(3):279-83. doi: 10.1097/qai.0b013e3182a97c39.

Abstract

We performed a randomized controlled trial in 30 HIV-infected participants to either continue tenofovir/emtricitabine/efavirenz (Continuation Group) or switch to tenofovir/emtricitabine/raltegravir (Switch Group) for 24 weeks. There were no significant differences in the changes in flow-mediated dilation, 25(OH) vitamin D, or parathyroid hormone levels. Total cholesterol, high sensitivity C-reactive protein, serum alkaline phosphatase, sCD14 levels, and renal function significantly declined in the Switch Group compared with the Continuation Group; however, sCD163 levels significantly increased in the Switch Group. These findings suggest that raltegravir is not inherently more beneficial to endothelial function compared with efavirenz but may impact renal function and monocyte activation.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenine / analogs & derivatives*
  • Adenine / blood
  • Adenine / therapeutic use
  • Adult
  • Alkaline Phosphatase / blood
  • Anti-HIV Agents / therapeutic use*
  • Biomarkers / blood
  • Bone and Bones / metabolism*
  • C-Reactive Protein / metabolism*
  • Cholesterol / blood
  • Deoxycytidine / analogs & derivatives*
  • Deoxycytidine / blood
  • Deoxycytidine / therapeutic use
  • Drug Combinations
  • Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
  • Endothelium, Vascular / drug effects*
  • Female
  • HIV Infections / blood
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • Humans
  • Indiana / epidemiology
  • Inflammation
  • Male
  • Organophosphonates / blood
  • Organophosphonates / therapeutic use*
  • Oxazines / blood
  • Oxazines / therapeutic use*
  • Pyrrolidinones / therapeutic use*
  • Raltegravir Potassium
  • Renal Insufficiency / blood
  • Renal Insufficiency / chemically induced*
  • Treatment Outcome
  • Viral Load

Substances

  • Anti-HIV Agents
  • Biomarkers
  • Drug Combinations
  • Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
  • Organophosphonates
  • Oxazines
  • Pyrrolidinones
  • Deoxycytidine
  • Raltegravir Potassium
  • C-Reactive Protein
  • Cholesterol
  • Alkaline Phosphatase
  • Adenine