CARDIOVASCULAR RISK FACTORS IN LONG-TERM TREATED PATIENTS WITH NEVIRAPINE VS EFAVIRENZ BASED REGIMENS

Our objective was to evaluate thè cardiovascular (CV) risk among pts treated for more than 5 years with regimens based on NVP or EFV examining traditional risk factors, and detecting thè presence of subclinical vascular lesions by means of colour Doppler ultrasonography. 276 pts have been evaluated. 156 of them in treatment with NVP, 120 with EFV. Data regarding risk factors for CV, have been evaluated at thè start of therapy (TO) and periodically re-checked. The pts were submitted to ultrasound at TO and at FU. At TO data regarding gender, age, period of treatment, percentage of HAART naives pts, risk factors for CV disease did not statistically differed between thè two groups. Comparing thè data at TO and at FU within NVP group, total cholesterol (TC), LDLc and triglycerides (TG) showed a significant decrease, HDLc increased significantly, while glycaemia and BMI did not show variations. In 67 pts (36 in NVP, 31 in EFV) ultrasound was available al TO and at FU. In NVP group ultrasound data did not show significant changes, while in EFV group thè number of pathologic findings significantly increased. Comparing thè two groups at TO and at FU, pts in NVP group had significantly higher values of TC, LDLc and TC at TO while, at FU, TC and LDLc become non significantly different, while TG become lower with respect to EFV group. Glycaemia was comparable at TO, while it become significantly lower in NVP group. Our data show a better lipid and glucose profile in NVP group, with a tendency to decrease of TC, LDLc and TG, and to increase of HDLc; while in EFV group we observed a tendency to thè increase of TC, LDLc, TG, BMI and glycaemia. However, being thè value of TG, thè only statistically different at FU, we conclude that both thè regimens seem generally safe among long-term treated pts. However, pts in EFV group show a significant tendency to develop a pathologic ultrasound finding with respect to NVP group. Both these regimens seem generally safe, although pts treated with NVP show a better lipid and glucose profile and a lower tendency to develop subclinical atherosclerotic lesions.