HIV Infection Clinical Trial
Official title:
Phase IV, Randomized, Open Label, Crossover, Intervention Trial to Investigate the Effect of the Switch of Lopinavir/Ritonavir to Raltegravir on Endothelial Function, Chronic Inflammation, Immune Activation and HIV Replication <50 Copies/ml
Treatment with HIV-infection with protease inhibitors is associated with high blood lipids and higher chance for cardiovascular complications. The RASSTER study aims to investigate the effect of switching the protease inhibitor lopinavir/ritonavir to raltegravir on vessel wall function and inflammation,and activation of the immune system. we hypothesize that with this intervention these parameters will improve. Since decreased vessel wall function and inflammation are initial steps in the process of atherosclerosis, it is important to know this data when treating HIV-infected patients.
Fixed dose combination lopinavir/ritonavir (LPV/r) is a widespread used antiretroviral drug
belonging to the class of protease inhibitors (PIs). PIs are associated with an increased
risk of myocardial infarction. However, data is available suggesting increased levels of
plasma lipids are not the sole explanation for this observation. Treatment with LPV/r might
lead to a decrease of endothelial function as well, thus explaining the increased risk of
myocardial infarction besides increased plasma lipids. Raltegravir is a registered
antiretroviral drug with no known cardiovascular side effects. We hypothesize that switching
LPV/r to raltegravir in HIV-infected patients with suppressed plasma viral load (<50
copies/ml) will lead to an improvement of endothelial function.
Objective:
- First, to assess the effect of the switch of lopinavir/ritonavir to raltegravir on
endothelial function.
- Second, to assess the effect of the intervention mentioned above on markers of
endothelial function; immune activation; chronic inflammation; and, on plasma HIV-RNA
below the cut-off of 50 copies/ml.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Open Label, Primary Purpose: Treatment
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