Dyslipidemia in patients taking anti-retroviral therapy
Keywords:
Dyslipidemia, HIV, Antiretroviral therapy, Lipid profile,Abstract
Background: People with human immunodeficiency virus (HIV) infection are living longer with the use of anti-retroviral therapy (ART). But as they do, non-HIV medical problems become more relevant. In particular dyslipidemia, an important reversible risk factor for cardiovascular disease, has been linked to HIV infection and its treatment. Its pathogenesis is complex and includes factor related to the virus, the host and ART. Our aim is to study the changes in the lipid profile in the patients of HIV taking ART.Â
Methods: Data were collected from 50 normotensive, non-diabetic and non-obese, HIV-infected patients who were on ART for at least 6 months at ART Center, Civil hospital, Ahmedabad, Gujarat and 50 healthy normal controls. Fasting lipid profiles were analyzed enzymatically by colorimetric method in fully automated Erba XL-640 Analyser.
Results: The level of serum total cholesterol (TC), serum triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) were increase while high-density lipoprotein cholesterol (HDL-C) were decrease in patients of HIV who were on ART for at least 6 month as compared to the normal subjects (p value <0.05).
Conclusion: The study has demonstrated dyslipidemia in HIV infected patients receiving ART. There is a need for monitoring lipid profile in patients on ART.
References
2) Boccara F. Cardiovascular complications and atherosclerotic manifestations in the HIV-infected population: type, incidence and associated risk factors. AIDS. 2008;3:S19–26.
3) Mehta N, Reilly M. Atherosclerotic cardi-ovascular disease risk in the HAART-treated HIV-1 population. Clin Trials. 2005;6:5–24.
4) Hoffmann C, Jaeger H. Cardiology and AIDS: HAART and the consequences. Ann N Y Acad Sci. 2001;946:130–44.
5) Leonard EG, McComsey GA. Metabolic complications of antiretroviral therapy in children. Pediatr Infect Dis J. 2003;22:77–84.
6) Floridia M, Tamburrini E, Ravizza M, Tibaldi C, Ravagni Probizer MF, Anzidei G, et al. Lipid profile during pregnancy in HIV-infected women. HIV Clin Trials. 2006;7:184–93.
7) Kramer AS, Lazzarotto AR, Sprinz E, Manfroi WC. Metabolic abnormalities, antiretroviral therapy and cardiovascular disease in elderly patients with HIV. Arq Bras Cardiol. 2009;93:561–8.
8) Troll JG. Approach to dyslipidemia, lipodystrophy, and cardiovascular risk in patients with HIV infection. Curr Atheroscler Rep. 2011;13:51–6.
9) Balasubramanyam A, Sekhar RV, Jahoor F, Jones PH, Pownall HJ. Pathophysiology of dyslipidemia and increased cardiovascular risk in HIV lipodystrophy: a model of ‘systemic steatosis’. Curr Opin Lipidol. 2004;15:59–67.
10) Monier PL, Wilcox R. Metabolic complications associated with the use of highly active antiretroviral therapy in HIV-1-infected adults. Am J Med Sci. 2004;328:48–56.
11) Powderly WG. Long-term exposure to life-long therapies. J Acquir Immune Defic Syndr. 2002;29 Suppl 1:S28–40.
12) Herman JS, Easterbrook PJ. The metabolic toxicities of antiretroviral therapy. Int J STD AIDS. 2001;12:555–62, quiz 563-4.
13) Dronda F. Cardiovascular risk in patients with chronic HIV-1 infection: a controversy with therapeutic, clinical and prognostic implications. Enferm Infecc Microbiol Clin. 2004;22:40–5.
14) Ducobu J, Payen MC. Lipids and AIDS. Rev Med Brux. 2000;21:11–7.
15) Sherer R. HIV, HAART, and hyperlipidemia: balancing the effects. J Acquir Immune Defic Syndr. 2003;34:S123–9.
16) ElÃas-Calles LC, Calero TMG. Dislipidemia y virus de inmunodeficiencia adquirida/SIDA. Rev Cuba Endocrinol. 2010;21:202–22.
17) Fantoni M, Autore C, Del Borgo C. Drugs and cardiotoxicity in HIV and AIDS. Ann N Y Acad Sci. 2001;946:179-99
18) Grinspoon S, Carr A. Cardiovascular risk and body fat abnormalities in HIV infected adults. N Engl J Med. 2005;352:48–62.
19) Sarni ROS, Souza FIS, Battistini TRB, Pitta TS, Fernandes AP, Tardini PC, et al. Lipodystrophy in children and adolescents with acquired immunodeficiency syndrome and its relationship with the antiretroviral therapy employed. J Pediatr. 2009;85:329–34.
20) Battistini TR, Sarni RO, Souza FIS, Pitta TS, Fernandes AP, Hix S, et al. Lipody-strophy, lipid profile changes, and low serum retinol and carotenoid levels in children and adolescents with acquired immunodeficiency syndrome. Nutrition. 2010;26:612–6.
21) Werner MLF, Pone MVS, Fonseca VM, Chaves CRMM. Lipodystrophy syndrome and cardiovascular risk factors in children and adolescents infected with HIV/AIDS receiving highly active antiretroviral therapy. J Pediatr. 2010;86:27–32.
22) Verkauskiene R, Dollfus C, Levine M, Faye A, Deghmoun S, Houang M, et al. Serum adiponectin and leptin concentrations in HIV-infected children with fat redistribution syndrome. Pediatr Res. 2006;60:225–30.
23) Christeff N, Melchior JC, Truchis P, Perronne C, Gougeon ML. Increased serum interferon alpha in HIV-1 associated lipodystrophy syndrome. Eur J Clin Invest. 2002;32:43–50.
24) Carr A, Samaras K, Chisholm DJ, Cooper DA. Pathogenesis of HIV-1-protease inhibitor-associated peripheral lipodystrophy, hyperlipidaemia, and insulin resistance. Lancet. 1998;351:1881–3.
25) Calza L, Manfredi R, Chiodo F. Hyperlipidaemia in patients with HIV-1 infection receiving highly active antiretroviral therapy: epidemiology, pathogenesis, clinical course and management. Int J Antimicrob Agents. 2003;22:89–99.
26) Vergès B, Petit JM. Blood lipid abnormalities during treatment with protease inhibitors. Presse Med. 2001;30:911–4.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2014 Vijay R Parmar, Asha Khubchandani, Janki Jadav, Viral Solanki, Sagar Gangwani
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).