Effect of Coadministration of Etonogestrel Implant and Antiretroviral Therapies Containing Efavirenz or Lopinavir/Ritonavir on the Metabolism of Women Living with HIV/AIDSTatiana R Rocha Prandini1, Maria Valeria Bahamondes2,3, Milena B Brito4, Eliana Amaral3, Luis Bahamondes2,3, Geraldo Duarte1, Silvana M Quintana1, Rui A Ferriani1,2 and Carolina Sales Vieira1,3*
- *Corresponding Author:
- Carolina Sales Vieira, MD, PhD
Department of Obstetrics and Gynecology
School of Medicine of Ribeirao Preto/USP
Av. Bandeirantes 3900, Campus Universitário
Ribeirao Preto, SP 14049-900, Brazil
Tel: +55 16 3602-2804
Fax: +55 16 3633-0946
E-mail: [email protected]
Received date: February 16, 2017; Accepted date: March 06, 2017; Published date: March 13, 2017
Citation: Prandini TRR, Bahamondes MV, Brito MB, Amaral E, Bahamondes L, et al. (2017) Effect of Coadministration of Etonogestrel Implant and Antiretroviral Therapies Containing Efavirenz or Lopinavir/Ritonavir on the Metabolism of Women Living with HIV/AIDS. J AIDS Clin Res 8:674. doi:10.4172/2155-6113.1000674
Copyright: © 2017 Prandini TRR, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Concomitant use of antiretroviral therapy (ART) and hormonal contraceptives should be safe for women while maintaining medication efficacy without causing significant immunological or metabolic changes. However, the metabolic effect of the concomitant use of etonogestrel (ENG)-releasing implant and commonly used ARTs is not known. Objective: To evaluate the effect of coadministration of ENG-releasing implant and ARTs containing lopinavir/ ritonavir or efavirenz on the metabolic parameters of women living with human immunodeficiency virus (HIV) infection/ acquired immune deficiency syndrome (AIDS). Methods: This is an open, prospective, non-randomized exploratory study. Forty-five women who sought to receive the ENG contraceptive implant were selected, including 15 non-ART users, 15 zidovudine/lamivudine (AZT/3TC)+lopinavir/ritonavir users and 15 AZT/3TC+efavirenz users for at least 3 months. Clinical and metabolic parameters were assessed before, during and 24 weeks after implant insertion. Results: At 24 weeks after ENG implant insertion, the group without ART showed a 4.7% increase in albumin level (p=0.03), a 6.2% decrease in total cholesterol level (p=0.03) and a 5.6% increase in alkaline phosphatase level (p<0.01), whereas the lopinavir/ritonavir group showed a 12.5% increase in aspartate aminotransferase (p=0.03). The efavirenz group showed a 12.9% decrease in low-density lipoprotein (p=0.03). The other results showed no significant changes during the 24 week study. The observed changes remained within the normal values for the parameters. Conclusion: Co-administration of ENG implant with ARTs containing lopinavir/ritonavir or efavirenz is not associated with clinically relevant metabolic changes in women living with HIV infection/AIDS, after a 6 month followup period.