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Updated: Jun 27, 2025
05:46
Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors
Published on: April 9, 2014
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Cardiometabolic Differences in People Living with HIV Receiving Integrase Strand Transfer Inhibitors Compared to
Wilhelm A J W Vos1,2, Nadira Vadaq1, Vasiliki Matzaraki1
1Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands.
Viruses
|April 27, 2024
Summary
Integrase strand transfer inhibitors (INSTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) impact HIV patient metabolomes differently. INSTIs show a more favorable cardiovascular disease risk profile compared to NNRTIs.
Area of Science:
- HIV/AIDS research
- Metabolomics and lipidomics
- Cardiovascular disease risk
Background:
- Combination antiretroviral therapy (cART) is standard for people living with HIV (PLHIV).
- Integrase strand transfer inhibitors (INSTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) are key cART components.
- Different cART regimens may influence non-AIDS comorbidities, including cardiovascular disease.
Purpose of the Study:
- To compare the metabolome and lipidome profiles of patients on INSTI-based versus NNRTI-based cART regimens.
- To investigate potential differences in cardiovascular disease risk associated with these drug classes.
Main Methods:
- Utilized untargeted metabolomic analysis (mass spectrometry) on plasma samples from the 2000HIV study (n=1646).
- Employed targeted lipoprotein and lipid analysis (nuclear magnetic resonance spectroscopy).
- Identified perturbed metabolic pathways using MetaboAnalyst software.
Main Results:
- Metabolome homogeneity observed within INSTI and NNRTI groups, but significant differences between groups.
- INSTI users exhibited altered levels of metabolites related to lipids, organic acids, and organoheterocyclic compounds.
- INSTI use was linked to a less favorable lipid profile than nevirapine but more favorable than doravirine, with INSTIs showing a better cardiovascular risk profile overall.
Conclusions:
- INSTI and NNRTI regimens induce distinct metabolic and lipidomic changes in PLHIV.
- NNRTIs demonstrate more heterogeneous cardiometabolic effects compared to INSTIs.
- INSTI-based cART may offer a more favorable cardiovascular disease risk profile than some NNRTI-based regimens.
Keywords:
combination antiretroviral therapyintegrase strand transfer inhibitorlipidslipoproteomemetabolomenon-nucleoside reverse transcriptase inhibitorMore Related Videos
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