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Factors related to low HDL-cholesterol in HIV-infected patients

  • 1,
  • 1,
  • 2,
  • 3,
  • 4,
  • 5,
  • 6 and
  • 1
Journal of the International AIDS Society200811 (Suppl 1) :P112

https://doi.org/10.1186/1758-2652-11-S1-P112

  • Published:

Keywords

  • Cardiovascular Risk Factor
  • Related Factor
  • Physical Exam
  • Anthropometric Parameter
  • Traditional Cardiovascular Risk Factor

Purpose of the study

Low HDL-cholesterol (HDL-C) levels are associated with an increased risk of cardiovascular disease (CVD). The objective of this study was to investigate the prevalence of low HDL-C in HIV-infected patients and related factors.

Methods

Multicenter, cross-sectional study of all HIV-infected patients on regular follow-up in five Andalusian hospitals (southern Spain) during March–August 2007. A questionnaire about cardiovascular risk factors (CVR) and a physical exam, including anthropometric parameters and blood pressure, were done in all cases. Recent fasting lab data (≤3 prior months) were available in all cases, which included lipid profile, glycaemia, CD4 cells count, and HIV viral load. Statistical analysis: SPSS 11.0.

Summary of results

Data are from 1,072 patients, 43.8% of whom had low HDL-C. The prevalence of low HDL-C was higher among patients diagnosed with AIDS than those without AIDS (47.7 vs. 41.1%; p = 0.037), those not on ART than those who were on ART (53.4 vs. 42.5; p = 0.01), those with detectable HIV viral load (55.2 vs. 40.2; p < 0.0001), with CD4 cell counts ≤350 cells/μL (53.9 vs. 40.1%; p < 0.0001), smokers than no smokers (46.8 vs. 38.8%; p = 0.014), and those with hypertriglyceridemia (58.6 vs. 34.3%; p < 0.0001). For patients on ART, the prevalence of low HDL-C was higher for those on PI than those taking NNRTI (52.1 vs. 31.4%; p < 0.0001). In the multivariate analysis, the following factors remained significant: tobacco use (OR 1.37, 95% CI 1,04–1.8; p = 0.04), hypertriglyceridemia (OR 2.94, 95% CI 2.2–3.8; p < 0.00001), CD4 cells count ≤350 cells/μL (OR 1.74, 95% CI 1.2–2.3; p < 0.0001), and detectable HIV viral load (OR 1.85, 95% CI 1.3–2.5; p < 0.0001).

Conclusion

Immunological and virological situation, in addition to traditional cardiovascular risk factors such as tobacco and hypertriglyceridemia, affect HDL-C levels in HIV-infected patients. For patients on ART, the use of PI is associated with a higher probability of low levels of HDL-C. Although it is not clear if the higher HDL-C levels associated with ART use are surrogates for decreased CVD risk, this may be another reason to start ART earlier.

Authors’ Affiliations

(1)
Hosp Virgen de la Victoria, Malaga, Spain
(2)
Hosp Carlos Haya, Malaga, Spain
(3)
Hosp Costa del Sol, Marbella, Spain
(4)
Hosp de la Axarquia, Velez-Malaga, Spain
(5)
Hosp de la Serrania, Ronda, Spain
(6)
Hosp de Antequera, Antequera, Spain

Copyright

© Puerta et al; licensee BioMed Central Ltd. 2008

This article is published under license to BioMed Central Ltd.

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