Increased serum lipids are associated with higher CD4 lymphocyte count in HIV-infected women

Michelle Floris-Moore, A. A. Howard, Y. Lo, J. H. Arnsten, N. Santoro, E. E. Schoenbaum

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Objective: Highly active antiretroviral therapy (HAART) has been associated with dyslipidaemia; however, the roles of immune status and non-HIV-disease risk factors remain unclear. Methods: A cross-sectional analysis of fasting lipids was carried out for 231 women, of whom 132 were HIV-infected and 99 were uninfected. The concentrations of total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, and apolipoprotein B (apo B) were measured. CD4 lymphocyte count, hepatitis C status, demographics, diet, and anthropometrics were also assessed. Results: A total of 132 women were HIV-infected [30 were antiretroviral-naive, 68 were on protease inhibitors (PIs), and 34 were on non-PI HAART]. HIV infection was associated with higher triglycerides, lower HDL-C, and, among obese women, higher total cholesterol and LDL-C. Non-PI and PI HAART were each independently associated with higher total cholesterol, LDL-C, and apo B, compared with being ART-naive. Among HIV-infected women, after adjustment for HAART use, women with a CD4 lymphocyte count ≥ 500cells/μL had total cholesterol 41.8mg/dL (P=0.002) and LDL-C 28.8mg/dL (P=0.01) higher, on average, than women with a CD4 count <200cells/μL. Women with a CD4 count of 200-499cells/μL had total cholesterol 26.31mg/dL higher, on average, than those with a CD4 count < 200 cells/μL (P=0.04), although differences in LDL-C did not reach significance (15.51mg/dL; P=0.12). A higher CD4 count was also associated with higher apo B (P<0.001). Active hepatitis C infection was associated with lower total cholesterol, LDL-C, triglycerides, and apo B. Conclusions: Higher CD4 lymphocyte counts were associated with higher lipid levels, suggesting that immune competence may independently affect the dyslipidaemia seen in the HAART era. In addition, it is important that hepatitis C status be assessed in studies of dyslipidaemia in the HIV-infected population.

Original languageEnglish (US)
Pages (from-to)421-430
Number of pages10
JournalHIV Medicine
Volume7
Issue number7
DOIs
StatePublished - Oct 2006

Keywords

  • Antiretroviral therapy
  • Drug use
  • Dyslipidaemia
  • Women

ASJC Scopus subject areas

  • Health Policy
  • Infectious Diseases
  • Pharmacology (medical)

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