Efectividad y seguridad del cambio a esquema basado en raltegravir en pacientes con infección por VIH dislipidémicos bajo terapia antirretroviral en Fundación Arriarán

Background: The impact of switching antiretroviral therapy (ART) regimenfor dyslipidemiamanagement in HIV-infected (HIV+) patients has not been reported in Chile. Aim: To assess effectiveness and safety at 12 months after switching to raltegravir-based regimenfor dyslipidemiamanagement. Methods: Retrospective cohort of HIV+ patients receiving ART at Arriaran Foundation, with dyslipidemiaswitched to raltegravir-based regimenfor lipid management. Results: 73 patients were included, receiving ART based in nonnucleoside reverse transcriptase inhibitor(NNRTI; 50,7%) or protease inhibitor (PI; 49,3%), with mixed dyslipidemia(42,5%) or isolated hypertriglyceridemia(57,5%). At baseline, median total cholesterol (TC) and triglycerides (TG) were 228 mg/dl and 420 mg/dl, respectively; undetectable viral load (VL) was present in 94,5% of patients. Backbone ART was switched in 58,4% and lipid-lowering therapy was used by 89,1% of them. At 12 months, there was a significant decrease in TG (-43,6%) and TC (-19,3%). No cases of virologic failure were observed, although 10,9% of patients had detectable VL at 12 months, mostly transient. Conclusions: Switching ART to raltegravir-based regimenin dyslipidemic patients receiving NNRTI or PI is associated with a significative decrease in TG and TC at 12 months. This strategy is safe, but VL can be increased temporarily.