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Mediators of Inflammation
Volume 2014 (2014), Article ID 803095, 10 pages
Clinical Study

Urinary Eicosanoid Metabolites in HIV-Infected Women with Central Obesity Switching to Raltegravir: An Analysis from the Women, Integrase, and Fat Accumulation Trial

1Vanderbilt University School of Medicine, Nashville, TN 37232, USA
2Medical University of South Carolina, Charleston, SC 29403, USA
3University of California, Los Angeles, CA 90035, USA
4Case Western Reserve University, Cleveland, OH 44106, USA
5Tufts University, Boston, MA 02111, USA
6University of Toronto, Toronto, ON, Canada M5R 0A3

Received 6 February 2014; Revised 10 May 2014; Accepted 11 May 2014; Published 1 June 2014

Academic Editor: Jonathan Peake

Copyright © 2014 Todd Hulgan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Chronic inflammation is a hallmark of HIV infection. Eicosanoids reflect inflammation, oxidant stress, and vascular health and vary by sex and metabolic parameters. Raltegravir (RAL) is an HIV-1 integrase inhibitor that may have limited metabolic effects. We assessed urinary F2-isoprostanes (F2-IsoPs), prostaglandin E2 (PGE-M), prostacyclin (PGI-M), and thromboxane B2 (TxB2) in HIV-infected women switching to RAL-containing antiretroviral therapy (ART). Thirty-seven women (RAL = 17; PI/NNRTI = 20) with a median age of 43 years and BMI 32 kg/m2 completed week 24. TxB2 increased in the RAL versus PI/NNRTI arm (+0.09 versus −0.02; ). Baseline PGI-M was lower in the RAL arm ( ); no other between-arm cross-sectional differences were observed. In the PI/NNRTI arm, 24-week visceral adipose tissue change correlated with PGI-M ( ; ) and TxB2 ( ; ) changes, with a trend seen for PGE-M ( ; ). In an adjusted model, age ≥ 50 years ( ) was associated with increased PGE-M ). In this randomized trial, a switch to RAL did not significantly affect urinary eicosanoids over 24 weeks. In women continuing PI/NNRTI, increased visceral adipose tissue correlated with increased PGI-M and PGE-M. Older age (≥50) was associated with increased PGE-M. Relationships between aging, adiposity, ART, and eicosanoids during HIV-infection require further study.