The use of highly active antiretroviral therapy (HAART) in HIV-infected patients has been associated with the development of risk factors for cardiovascular diseases (CD) including dyslipidemia and insulin resistance, hypertriglyceridemia being the most frequent metabolic disturbance in these patients. Fibrates are indicated when hypertriglyceridemia is accentuated and persists for over six months. We evaluated the efficacy and safety of bezafibrate for the treatment of hypertriglyceridemia in HIV-infected individuals on HAART. All patients received 400mg/day of bezafibrate and were evaluated three times: Mo (pre-treatment), M1 (one month after treatment), and M2 (six months after treatment). Fifteen adult individuals, eight males and seven females with mean age = 41.2 +/- 7.97 years and triglyceride serum levels > 400mg/dL were included in the study. Smoking, alcohol ingestion and sedentarism rates were 50%, 6.66% and 60%, respectively. Family history of CD, hypertension and diabetes mellitus was reported in 33.3%, 40% and 46.7% of the cases, respectively, while dyslipidemia was reported by only 13.3%. More than half of the patients were using a protease inhibitor plus a nucleotide analog transcriptase inhibitor. Eutrophy and tendency toward overweight were observed at all three study time points. There were significant reductions in triglyceride serum levels from Mo to M1 and from Mo to M2. No significant changes were observed in the serum levels of creatine phosphokinase, hepatic enzymes, CD4+, CD8+ and viral load. Therefore, bezafibrate seems to be safe and effective for the reduction of hypertriglyceridemia in HIV-infected patients on HAART.
Pathological conditions, changes in diet composition, presence of gastrointestinal disorders and/or ingestion of drugs may alter the normal intestinal microbiota, regardless of its high stability. The association of infection with the use of medicines makes difficult the interpretation of the involvement of these factors in intestinal microbiota. The aim of the present study was to evaluate the intestinal microbiota of individuals injured by biological materials in occupational accidents and that were subjected to antiretroviral prophylaxis. Twenty-three adults aged 18-45 years old were studied; among them, 13 individuals were blood donors (control group) and 10 were injured by biological materials in occupational accidents and subjected to anti-retroviral prophylaxis. Their intestinal microbiota was evaluated together with anthropometric measurements and biochemical tests (blood count, renal and hepatic functions, blood glucose and lipid levels, total proteins and their fractions) before, right after and 30 days after the end of medication. Administration of zidovudine plus iamivudine was associated with nelfinavir in 70% individuals, with efavirenz in 20%, and with ritonavir in 10%. Nausea, vomiting and diarrhea were present in 80% of the individuals in the second part of the study. Overweight was noticed in 70% individuals and malnutrition and eutrophia in 10%, and no alterations were observed during the study. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyl transferase (Gamma-GT) and triglycerides, and low-density lipoprotein (LDL) cholesterol enzymes increased in the second part of the study and normalized 30 days after the end of treatment. A significant reduction was observed in the number of anaerobic bacteria of all three genera evaluated -Lactobacillus, Bifidobacterium and Bacteroides -compared with the control group at all three moments. The use of antiretroviral drugs caused significant impact on the intestinal microbiota of normal individuals, with no recovery 30 days after the end of medication.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.