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    Evaluation of cardiovascular biomarkers In HIV-infected patients switching to abacavir or tenofovir based therapy

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    Author
    Rasmussen, TA; Tolstrup, M; Melchjorsen, J; Frederiksen, CA; Nielsen, US; Langdahl, BL; Ostergaard, L; Laursen, AL
    Date
    2011-10-04
    Source Title
    BMC Infectious Diseases
    Publisher
    BIOMED CENTRAL LTD
    University of Melbourne Author/s
    Rasmussen, Thomas
    Affiliation
    Doherty Institute
    Metadata
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    Document Type
    Journal Article
    Citations
    Rasmussen, T. A., Tolstrup, M., Melchjorsen, J., Frederiksen, C. A., Nielsen, U. S., Langdahl, B. L., Ostergaard, L. & Laursen, A. L. (2011). Evaluation of cardiovascular biomarkers In HIV-infected patients switching to abacavir or tenofovir based therapy. BMC INFECTIOUS DISEASES, 11 (1), https://doi.org/10.1186/1471-2334-11-267.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/258369
    DOI
    10.1186/1471-2334-11-267
    Abstract
    BACKGROUND: Our objective was to evaluate and compare the effect of abacavir on levels of biomarkers associated with cardiovascular risk. METHODS: In an open-label randomized trial, HIV-infected patients were randomized 1:1 to switch from zidovudine/lamivudine to abacavir/lamivudine or tenofovir/emtricitabine. In the present analysis, we measured levels of interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular adhesion molecule-1 (sVCAM-1), E-selectin, and myeloperoxidase (MPO) at baseline and 4, 12, and 48 weeks after randomization. D-dimer and fasting lipids were measured at baseline and weeks 12 and 48. Levels of biomarkers at all time points and changes from baseline were compared across study arms using Wilcoxon rank sum test. RESULTS: Of 40 included patients, 35 completed 48 weeks of randomized therapy and follow up. Levels of E-selectin (P=0.004) and sVCAM-1 (P=0.041) increased transiently from baseline to week 4 in the abacavir arm compared with the tenofovir arm, but no long-term increases were detected. We found no significant differences between study arms in the levels or changes in the levels of sICAM-1, MPO, d-dimer, IL-6, or hs-CRP. Levels of total cholesterol and high density lipoprotein (HDL) increased in the abacavir arm relative to the tenofovir arm, but no difference was found in total cholesterol/HDL ratio. CONCLUSION: In patients randomized to abacavir-based HIV-treatment transient increases were seen in the plasma levels of E-selectin and sVCAM-1 compared with treatment with tenofovir, but no difference between study arms was found in other biomarkers associated with endothelial dysfunction, inflammation, or coagulation. The clinical significance of these findings is uncertain. TRIAL REGESTRATION: Clinicaltrials.gov identifier: NCT00647244.

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