Dyslipidemia and fasting glucose impairment among HIV patients three years after the first antiretroviral regimen in a Brazilian AIDS outpatient clinic

Neto, Lauro Ferreira da Silva Pinto; Neves, Mariza Barros das; Ribeiro‐Rodrigues, Rodrigo; Page, Kimberly; Miranda, Angélica Espinosa

doi:10.1016/j.bjid.2012.12.006

Cited by 21 publications

(15 citation statements)

References 30 publications

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“…Although increased oxidative stress [35] and dyslipidemia [9, 36] are some of the most evident side effects, in our study, no differences in glucose and total cholesterol levels were observed after therapeutic intervention. However, we cannot exclude that longer treatment could provoke these problems, as Pinto Neto et al [35] observed that dyslipidemia and glucose disturbances occurred after three years of cART use. On the other hand, in our study, patients showed a significant increase in triglyceride levels already in the first months of treatment, with no influence of the scheme used, protease inhibitors (PI), or NNRTI (data not shown).…”

Section: Discussioncontrasting

confidence: 61%

“…Despite the benefits of cART in the stabilization of HIV infection, there is evidence that the therapy is accompanied by some adverse effects, especially considering its long-term administration [9, 35]. Although increased oxidative stress [35] and dyslipidemia [9, 36] are some of the most evident side effects, in our study, no differences in glucose and total cholesterol levels were observed after therapeutic intervention.…”

Section: Discussioncontrasting

confidence: 55%

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The Initial Months of Antiretroviral Therapy and Its Influence on AGEs, HMGB1, and sRAGE Levels in Asymptomatic HIV-Infected Individuals

Tasca

Caleffi

Corrêa

et al. 2016

Mediators of Inflammation

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The development of the typical comorbidities of aging which currently affects people living with HIV/AIDS (PLWHA) can be partially ascribed to the persistent immune activation and chronic inflammation characterizing these individuals. The aim of this study was to analyze the effect exerted by combined antiretroviral therapy (cART) administration on plasma levels of HMGB1 (high mobility group box protein-1), AGEs (advanced glycation end products), their soluble receptor sRAGE, cytokines, C-reactive protein (CRP), and some metabolic markers in asymptomatic PLWHA. Analyses were performed longitudinally in 30 PLWHA, before and about 6–12 months after cART initiation. We observed that lower levels of AGEs in post-cART group were accompanied by an increase of CRP and triglyceride levels already in the early months of therapy. Because of the current ever-earlier recommendations to start cART and its prolonged use, these and other markers should be investigated in order to monitor and postpone the appearance of non-AIDS comorbidities in PLWHA.

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Section: Discussioncontrasting

confidence: 61%

Section: Discussioncontrasting

confidence: 55%

The Initial Months of Antiretroviral Therapy and Its Influence on AGEs, HMGB1, and sRAGE Levels in Asymptomatic HIV-Infected Individuals

Tasca

Caleffi

Corrêa

et al. 2016

Mediators of Inflammation

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“…According to the D:A:D, a consortium assessing adverse events of anti-HIV drugs, the risk associated to certain PI’s (indinavir, lopinavir/ritonavir, abacavir) was consistently lower than the one calculated to the annual increment in risk associated to advanced age and current smoking habit [67]. The use of lopinavir/ritonavir [68], stavudine [63], efavirenz [69] and nelfinavir, zidovudine/lamivudine and didanosine/stavudine [70] have already been reported as causative of dyslipedemia by at least one of the following mechanisms (i) increased TG levels, (ii) increased LDL-c levels, and (iii) increased HDL-c levels.…”

Section: Reviewmentioning

confidence: 99%

Metabolic syndrome in HIV-infected individuals: underlying mechanisms and epidemiological aspects

2013

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The success of highly active antiretroviral therapy (HAART) has determined a dramatic decline in AIDS- and immunodeficiency-related causes of death in the HIV-infected population. As life-expectancy increases, such individuals have become gradually exposed not only to the effects of aging itself, but also to the influence of environmental risk factors, which are known to act in the general population. These features can lead to obesity, diabetes mellitus and ultimately cardiovascular diseases (CVD). Metabolic complications and abnormal fat distribution were frequently observed after a few years of antiretroviral therapy and, as the array of antiretroviral drugs became broader, long term metabolic alterations are becoming far more common worldwide. Nevertheless, the risk of not being on HAART is overwhelmingly greater than the metabolic adverse events in terms of morbidity and mortality events. HIV/HAART-induced metabolic unbalances overlap in some extent the components of Metabolic Syndrome (MetS) and its high rates in the HIV population place infected individuals in an elevated CVD risk category. MetS can explain at least in part the emergence of CVD as the major morbidity and mortality conditions in the HIV population. In this review we convey information on the underlying aspects of MetS during HIV infection, highlighting some physiopathological and epidemiological features of this comorbidity along with the role played by HIV itself and the synergy action of some antiretroviral drugs. Considerations on MetS management in the HIV population are also depicted.

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“…Association between cART and DRCs has been long suspected [ 4 , 6 , 7 ]. Studies have provided evidence showing that this association may depend not only on the duration of exposure to cART [ 8 ] but also the type of cART regimen taken [ 4 ]. In other words, while cART is considered a providential life-saving treatment for persons living with HIV (PLWH), it also has the potential of taking away lives by exposing recipients to an array of unwanted illnesses like diabetes mellitus and related complications [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Some experts have reported these associations only with regimens containing protease inhibitors [ 13 ], while others have described DRCs association with all types cART regimens [ 6 , 7 , 14 ]. The average time duration from cART initiation to the development of DRCs also significantly differed from one study to another [ 8 , 14 ]. However, these results are perhaps due to differences in patient characteristics.…”

Section: Introductionmentioning

confidence: 99%

Relationship between combination antiretroviral therapy regimens and diabetes mellitus-related comorbidities among HIV patients in Gaborone Botswana

et al. 2018

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BackgroundCombination antiretroviral therapy (cARTs) regiments are known to prolong the recipients’ life even though they are risk factors for diabetes mellitus-related comorbidities (DRCs). We sought to: (i) examine cART relationship with DRCs among patients attending HIV clinics in Gaborone, Botswana (which cART regimens are associated with shorter/longer time to the event), (ii) characterize patients’ underlying biomedical and demographic risk factors of DRC and identify the most important, (iii) investigate survival of patients on different cART regimens in the presence of these risk factors.MethodsData from two major HIV clinics in Botswana were reviewed. Relationships between different cART regimens and DRCs were investigated among 531 recipients. Recipients’ DRC risk factors were identified. Cox regression model was run. Unadjusted and adjusted hazard ratios were computed, and hazard and survival functions for different cART regimens were plotted.ResultsMajor findings were: patients on second- and third-line cART were less likely to develop DRCs earlier than those on first-line cART. Patients with CD4 count ≤ 200 cells/mm3 at cART initiation were more likely to develop DRCs earlier than those who had CD4 count > 200 cells/mm3. Overweight patients at cART initiation had a higher risk of developing DRCs earlier than those who had normal body mass index. Males had a lower risk of developing DRCs earlier than females.ConclusionThe risk of new onset of DRC among cART recipients is a function of the type of cART regimen, duration of exposure and patients’ underlying biomedical and demographic DRC risk factors. The study has provided a survival model highlighting DRCs’ significant prognostic factors to guide clinical care, policy and management of recipients of cARTs. Further studies in the same direction will likely improve the survival to the development of DRC of every cART recipient in this community.

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Dyslipidemia and fasting glucose impairment among HIV patients three years after the first antiretroviral regimen in a Brazilian AIDS outpatient clinic

Abstract: These data show high chance of dyslipidemia after initiation of ART. Long-term follow-up will help identify the impact of ART on cardiovascular risk.

Cited by 21 publications

References 30 publications

The Initial Months of Antiretroviral Therapy and Its Influence on AGEs, HMGB1, and sRAGE Levels in Asymptomatic HIV-Infected Individuals

The Initial Months of Antiretroviral Therapy and Its Influence on AGEs, HMGB1, and sRAGE Levels in Asymptomatic HIV-Infected Individuals

Metabolic syndrome in HIV-infected individuals: underlying mechanisms and epidemiological aspects

Relationship between combination antiretroviral therapy regimens and diabetes mellitus-related comorbidities among HIV patients in Gaborone Botswana

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