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Effects of Switching From Efavirenz to Raltegravir on Endothelial Function, Bone Mineral Metabolism, Inflammation, and Renal Function: A Randomized, Controlled Trial

Gupta, Samir K. MD, MS*; Mi, Deming MS; Moe, Sharon M. MD*; Dubé, Michael P. MD*,‡; Liu, Ziyue PhD

JAIDS Journal of Acquired Immune Deficiency Syndromes: November 1st, 2013 - Volume 64 - Issue 3 - p 279–283
doi: 10.1097/QAI.0b013e3182a97c39
Brief Report: Clinical Science

Abstract: We performed a randomized controlled trial in 30 HIV-infected participants to either continue tenofovir/emtricitabine/efavirenz (Continuation Group) or switch to tenofovir/emtricitabine/raltegravir (Switch Group) for 24 weeks. There were no significant differences in the changes in flow-mediated dilation, 25(OH) vitamin D, or parathyroid hormone levels. Total cholesterol, high sensitivity C-reactive protein, serum alkaline phosphatase, sCD14 levels, and renal function significantly declined in the Switch Group compared with the Continuation Group; however, sCD163 levels significantly increased in the Switch Group. These findings suggest that raltegravir is not inherently more beneficial to endothelial function compared with efavirenz but may impact renal function and monocyte activation.

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*Departments of Medicine;

Biostatistics, Indiana University School of Medicine, Indianapolis, IN; and

Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.

Correspondence to: Samir K. Gupta, MD, MS, Division of Infectious Diseases, Indiana University School of Medicine, Emerson Hall, Suite 421, 545 Barnhill Drive, Indianapolis, IN 46202 (e-mail:

Supported by an unrestricted research grant from Merck & Co. with additional support from National Institutes of Health (NIH) Grant HL095149 and the Indiana Clinical and Translational Sciences Institute funded, in part, by grant TR000006 from the NIH, National Center for Advancing Translational Sciences, Clinical and Translational Sciences Award.

S.K.G. has received unrestricted research grants from Merck & Co., Inc. Janssen/Tibotec Therapeutics, and Gilead Sciences, Inc. S.K.G. received compensation for 1 lecture in 2012 from Merck & Co., Inc. pertaining to HIV-related renal disease and had received travel support from Gilead Sciences in 2011 to present data at the 6th International AIDS Society Conference for a tenofovir-related study. M.P.D. has received unrestricted research grants from Gilead Sciences, Inc. and Serono. The remaining authors have no conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

Received June 09, 2013

Accepted August 12, 2013

© 2013 by Lippincott Williams & Wilkins