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Antiretroviral therapy in HIV‐positive men is associated with increased apolipoprotein CIII in triglyceride‐rich lipoproteins
Author(s) -
Rimland D,
Guest JL,
Hernández I,
Del Rio C,
Le NA,
Brown WV
Publication year - 2005
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2005.00316.x
Subject(s) - medicine , triglyceride , apolipoprotein b , endocrinology , lipoprotein , antiretroviral therapy , cholesterol , high density lipoprotein , gastroenterology , human immunodeficiency virus (hiv) , immunology , viral load
Objectives Dyslipidaemia has become a common problem in HIV disease, especially in patients on current antiretroviral therapy. However, the pathogenic mechanisms involved are not well understood or documented using conventional lipid measurements. Methods Using a cross‐sectional design, the prevalence of abnormal standard lipid measurements and novel biomarkers for abnormal lipid metabolism was determined in 271 HIV‐positive men from two HIV clinics in Atlanta, GA, USA. Results A total of 147 men were treated with protease inhibitors (PIs) for >3 months (54%), 84 were treated with nonnucleoside reverse transcriptase inhibitors (NNRTIs) for >3 months (31%) and 40 had not received antiretroviral therapy in the past 3 months (15%). Patients being treated with a PI had higher total cholesterol and triglyceride (TG) levels than patients on no therapy ( P <0.05 for each). Patients in the NNRTI group had higher TG, lower high‐density lipoprotein (HDL) levels, and higher low‐density lipoprotein (LDL) levels than patients on no therapy ( P <0.05 for each). Patients treated with either PIs or NNRTIs were more likely to have higher apolipoprotein CIII (apoCIII) levels ( P <0.05 for each) than patients on no therapy. Elevated TG was associated with disproportionably elevated apoCIII levels in both treatment groups. Conclusions In this cross‐sectional study of HIV‐infected men, either PI or NNRTI therapy elevated levels of TG and apoCIII. Higher concentrations of apoCIII in apoB‐containing lipoproteins [very low‐density lipoproteins (VLDLs), intermediate density lipoprotein (IDL) and LDLs] have been predictive of an increased incidence of coronary events in clinical trials and more rapid progression of coronary lesions measured by angiography. These findings, on a background of an older population with additional risk factors of smoking and diabetes, portend future atherosclerotic events in these patients.