Abstract
BackgroundDyslipidemia is commonly seen in human immunodeficiency virus (HIV) infected patients. Understanding the risk factors of abnormal lipid profiles is urgent for proposing targeted approaches to prevention. Our objective was to assess the incidence and associated factors of abnormal lipid profiles and atherogenic index of plasma (AIP) among antiretroviral therapy (ART) naïve men who have sex with men (MSM) acute HIV infection (AHI) and chronic HIV infection (CHI) patients in China.MethodsWe compared lipids parameters such as triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and AIP between MSM HIV-infected patients and MSM HIV negative controls. Multivariable linear regression was used to evaluate risk factors of higher AIP.ResultsWe performed a case control analysis of 110 AHI, 110 CHI and 100 HIV negative MSM participants. The TC, HDL-C and LDL-C levels were decreased in the AHI and CHI groups compared to the controls (3.90 ± 0.73 mmol/L and 3.72 ± 0.74 mmol/L versus 4.49 ± 0.91 mmol/L, p < 0.001; 1.00 ± 0.25 mmol/L and 1.01 ± 0.30 mmol/L versus 1.19 ± 0.29 mmol/L, p < 0.001; 2.11 ± 0.57 mmol/L and 2.22 ± 0.58 mmol/L versus 2.75 ± 0.78 mmol/L, p < 0.001). The AIP score was higher in the AHI patients compared to the control group [0.08 (−0.05–0.20) versus−0.04 (−0.21–0.22), p = 0.039]. In total groups, AIP was associated with AHI and TG positively (β = 0.029 ± 0.012, p = 0.015;β = 0.273 ± 0.009, p < 0.001) and correlated with HDL-C inversely (β = -0.444 ± 0.023, p < 0.001).ConclusionsHIV infection contributed to decreased TC, LDL-C and HDL-C. AHI contributed to higher AIP level. An urgent need exists for earlier HIV diagnosis and better prevention of dyslipidemia in China.
Highlights
Dyslipidemia is commonly seen in human immunodeficiency virus (HIV) infected patients
In the chronic HIV infection (CHI) group we found that TG (β = 0.214 ± 0.018, p < 0.001), total cholesterol (TC) (β = 0.138 ± 0.049, p = 0.006) and low-density lipoprotein cholesterol (LDL-C) (β = 0.100 ± 0.048, p = 0.040) were positively correlated with atherogenic index of plasma (AIP) and significant inversely correlation was noticed between AIP and highdensity lipoprotein cholesterol (HDL-C) (β =−0.638 ± 0.066, p < 0.001)
Our study revealed that low levels of TC, HDL-C and LDL-C occurred in both acute HIV infection (AHI) and CHI groups
Summary
Dyslipidemia is commonly seen in human immunodeficiency virus (HIV) infected patients. HIV infection may lead to structural and functional changes in HDL-C [9] In both ART‐naïve chronic HIV infection (CHI) adult and children patients, low HDL-C was the most frequently observed abnormality and there existed a significant relationship between lipid parameters and viral load [10, 11]. Results from the Veterans Aging Cohort Study showed that HIV infection was associated with decreased TC, HDL-C, LDL-C and elevation of TG, ART initiation did not reverse alteration in TG or LDL-C to pre-HIV infection levels [12]. This suggests that HIV infection may influence lipids regardless of ART status. Experiment in vitro demonstrated that the high viremia levels of acute HIV infection (AHI) impaired cholesterol efflux capacity, which indicated that dyslipidemia may occur very early [13]
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