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| Publication Abstract Display | | Type: Poster | | Title: Effect of second generation antipsychotics on metabolic variables in HIV-infected adults on long term antiretroviral therapy. | | Authors: Ferrara M, Umlauf A, FitzSimons C, Meyer J, Duarte N, Atkinson JH, Grant I, Ellis R, for the CHARTER Group | | Date: 07-22-2012 | | Abstract:Background: Psychiatric disorders are common among HIV-infected adults, but there is no data
on the interaction between the metabolic side effects of antiretroviral therapy (ART) and those of
second-generation antipsychotics (SGAs).
Methods: A cross sectional study was conducted in participants consecutively recruited at the
UCSD HIV Neurobehavioral Research Program examining use of SGAs and ART, metabolic
outcomes, biomarkers of HIV disease, and hepatitis C (HCV) serostatus. Psychiatric diagnoses
were obtained using standardized psychodiagnostic assessment for DSM-IV disorders.
Metabolic outcome variables and covariates were compared for participants taking concomitant
SGA (SGA+) or not (SGA-) using t-tests, Chi-squared or Fisher's exact tests. Linear and logistic
multivariate models explored between-group outcome, after controlling for demographic and
disease covariates.
Results: Participants were 2229 research volunteers, 81% were men, 47% were Caucasian,
with a median nadir and current CD4 respectively of 117 and 436 cells/mm3. Compared to the
SGA- group (n=1971), the SGA+ group (n=258, 11.6% of the total sample) had a significantly
higher proportion of female (25% vs. 18%) and African American (40% vs. 32%) participants
than the SGA- group. Groups did not differ significantly on age, nadir or current CD4 cell counts,
or HIV viral load. SGA+ participants were less likely to be on an efavirenz-containing ART
regimen and had a higher prevalence of lifetime substance use disorders, bipolar disorder, and
current major depressive disorder. The multivariate model showed higher level of triglycerides
(p=0.01), higher odds of diabetes (p=0.004) and numerically higher BMI (p=0.06) in the SGA+
group. SGA+ participants had lower SBP (p=0.02) and higher DBP (p=0.004) than SGAparticipants.
Conclusions: Use of SGAs in HIV-infected adults taking ART was independently associated
with worse metabolic parameters, which might accelerate mortality and morbidity through
vascular disease. Further research is needed to investigate possible mechanisms behind the
metabolic complications of SGA and ART use. |
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