November 13, 2012
A study by David A. Kamara of the University College London and colleagues found that persons with HIV infection on a regimen of suppressive antiretrovirals have high levels of total cholesterol, HDL cholesterol, and triglycerides.
The researchers investigated the effects of ART, HIV viremia, and immunosuppression on levels of total cholesterol, HDL cholesterol, and triglycerides in participants of the Data Collection on Adverse Events of Anti-HIV Drugs (DAD) study. At, or soon after, enrollment in the study, 91 percent of the 50,000 participants supplied a total cholesterol measurement, 89 percent provided a triglyceride measurement, and 78 percent an HDL measurement.
Data show that participants who were off ART had lower lipid levels compared with those on ART and had a suppressed viral load. Non-suppressive ART was associated with lower levels of total cholesterol and HDL cholesterol, but did not affect triglycerides. A low current CD4 count was also associated with lower lipid levels, and the lowest CD4 count was associated with higher total cholesterol and triglyceride levels. Also, patients with a prior AIDS diagnosis had higher total cholesterol and triglyceride levels, but lower HDL cholesterol levels.
The higher total cholesterol and triglyceride and lower HDL cholesterol levels among those with the lowest level CD4 count and with a previous AIDS diagnosis suggests severe immunosuppression may be associated with dyslipidemia. Three-quarters of the participants were men, three-quarters did not have AIDS, and half were white. Participants' treatment history showed that 61 percent had prior experience with ART, 47 percent had experience with protease inhibitors, 61 percent with nucleotide reverse transcriptase inhibitors, 29 percent with non-nucleoside reverse transcriptase inhibitors, and 4 percent were not receiving anti-lipid drugs. Kamara concluded that lipid levels were considerably higher for participants on a suppressive ART regimen. He stated that future longitudinal analyses will consider the impact of specific ARTs and the duration of ART on lipid levels.
The report was presented at HIV11 Congress; Nov. 11-15, 2012, in Glasgow Scotland.