Metabolic, mitochondrial, renal and hepatic safety of enfuvirtide and raltegravir antiretroviral administration: Randomized crossover clinical trial in healthy volunteers

PLoS One. 2019 May 23;14(5):e0216712. doi: 10.1371/journal.pone.0216712. eCollection 2019.

Abstract

Context: Classical antiretroviral agents may acutely impact on metabolic, mitochondrial, renal and hepatic function in HIV-infected and uninfected persons. Fusion and integrase inhibitors are supposed to be safer, but have been scarcely investigated. To avoid any interference with HIV or other antiretrovirals, we assessed markers of these toxicities in healthy adult volunteers treated with Enfuvirtide (T20) or Raltegravir (RAL).

Methods: Twenty-six healthy participants were randomized to T20/90mg vs. placebo (n = 12) or RAL/400mg vs. placebo (n = 14) every 12h in two 7-day periods separated by a 4-week washout period. Major end-points were changes in lipid profile (total cholesterol, high-density-lipoprotein (HDL)-cholesterol, low-density-lipoprotein (LDL)-cholesterol, triglycerides), insulin resistance (glucose) and mitochondrial toxicity (mitochondrial DNA content-mtDNA-in peripheral blood mononuclear cells). Renal and hepatic toxicity (creatinine, alanine transaminase (AST), alanine aminotransferase (ALT), bilirubin and total plasma proteins) and overall safety were also analysed. Effect of period, treatment, and basal measures were evaluated for each end-point.

Results: Neither T20-administration nor RAL-administration yielded to any statistic significant change in the markers of metabolic, mitochondrial, renal or hepatic toxicity assessed. No symptoms indicative of drug toxicity were neither found in any subject.

Conclusions: In absence of HIV infection, or concomitant treatment, short-term exposure to T20 or RAL in healthy adult volunteers did not lead to any indicative changes in toxicity markers thus presuming the safe profile of both drugs.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alanine Transaminase / analysis
  • Alanine Transaminase / blood
  • Anti-Retroviral Agents / therapeutic use
  • Creatine / analysis
  • Creatine / blood
  • Enfuvirtide / metabolism
  • Enfuvirtide / pharmacology*
  • Enfuvirtide / toxicity
  • HIV Infections / drug therapy
  • Healthy Volunteers
  • Humans
  • Insulin Resistance
  • Kidney / drug effects
  • Leukocytes, Mononuclear / metabolism
  • Lipids / analysis
  • Liver / drug effects
  • Male
  • Metabolism / drug effects
  • Mitochondria / drug effects
  • Raltegravir Potassium / metabolism
  • Raltegravir Potassium / pharmacology*
  • Raltegravir Potassium / toxicity

Substances

  • Anti-Retroviral Agents
  • Lipids
  • Enfuvirtide
  • Raltegravir Potassium
  • Alanine Transaminase
  • Creatine

Grants and funding

This work was supported by: Fundación para la Investigación y la Prevención del SIDA en España [FIPSE 360982/10]; Fondo de Investigación Sanitaria [FIS 01199/11, FIS 00462/11, FIS 01199/12, FIS 01738/13, FIS 01455/13, PI00005/14, PI00817/15, PI00903/15 and PI00130/15]; CIBERER and InterCIBER [PIE1400061], both supported granted by Instituto de Salud Carlos III and cofinanced by the Fondo Europeo de Desarrollo Regional de la Unión Europea “Una manera de hacer Europa”; Suports a Grups de Recerca [SGR 2014/376 and 2014/SGR928] and CERCA Programme from the Generalitat de Catalunya; CONACyt; Marató de TV3 [87/C/2015]; Fundació Cellex; and “la Caixa” Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.