Association of serum lipid levels with HIV serostatus, specific antiretroviral agents, and treatment regimens

Kathryn Anastos, Dalian Lu, Qiuhu Shi, Phyllis C. Tien, Robert C. Kaplan, Nancy A. Hessol, Steven Cole, Cheryl Vigen, Mardge Cohen, Mary Young, Jessica Justman

85 Scopus citations

Abstract

BACKGROUND: The effects of HIV infection, highly active antiretroviral therapy (HAART), and specific antiretroviral agents on lipoproteins in women are not well described. METHODS: In a cross-sectional substudy of the Women's Interagency HIV Study with 623 HIV-negative and 1556 HIV-positive women (636 untreated, 419 on non-protease inhibitor [PI] HAART, and 501 on PI-containing HAART), we performed multivariate analyses of associations among fasting lipoprotein levels, HIV infection, and HAART. RESULTS: Untreated HIV-positive women had lower high-density lipoprotein cholesterol (HDL-C) and higher triglycerides (TGs) but not lower low-density lipoprotein cholesterol (LDL-C) than HIV-negative women and were the most likely to have unfavorable HDL-C by National Cholesterol Education Program (NCEP) guidelines. PI HAART users had higher LDL-C than untreated HIV-infected women (107 vs. 100 mg/dL, P = 0.0006) and were the most likely to have unfavorable LDL-C and TGs by NCEP guidelines. HIV-negative women and non-PI HAART users had similar HDL-C levels (55 and 53 mg/dL, respectively), which were higher than those in untreated HIV-infected women and PI HAART users (42 and 49 mg/dL, respectively; P < 0.001 for all). Lamivudine, didanosine, nevirapine, and efavirenz were independently associated with higher HDL-C (P < 0.001 for all). Ritonavir, indinavir/ritonavir, and nelfinavir were associated with higher LDL-C (P < 0.01 for all). Stavudine, abacavir, and all ritonavir-containing regimens were associated with higher TGs (P < 0.05 for all), and tenofovir was associated with lower TGs (P = 0.009). CONCLUSIONS: A dyslipidemic pattern was associated with HIV infection itself, was more severe in users of PI-containing HAART, but was not present in women taking non-PI HAART.

Original languageEnglish (US)
Pages (from-to)34-42
Number of pages9
JournalJournal of Acquired Immune Deficiency Syndromes
Volume45
Issue number1
DOIs
StatePublished - May 1 2007

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Keywords

  • High-density lipoprotein
  • Highly active antiretroviral therapy
  • Lipids
  • Low-density lipoprotein
  • Women

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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