Association of subclinical atherosclerosis with lipid levels amongst antiretroviral-treated and untreated HIV-infected women in the Women's Interagency HIV study

Abstract

Objective We examined serum lipids in association with carotid artery intima-media thickness (CIMT) in HIV-infected and HIV-uninfected women. Methods In 2003–4, among 1827 Women’s Interagency HIV Study participants, we measured CIMT and lipids (high-density lipoprotein cholesterol [HDL-c], low-density lipoprotein cholesterol [LDL-c], total cholesterol [TC], non-HDL-c). A subset of 520 treated HIV-infected women had pre-1997 lipid measures. We used multivariable linear regression to examine associations between lipids and CIMT. Results In HIV-uninfected women, higher TC, LDL-c and non-HDL-c were associated with increased CIMT. Among HIV-infected women, associations of lipids with CIMT were observed in treated but not untreated women. Among the HIV-infected women treated in 2003–4, CIMT was associated both with lipids measured a decade earlier in infection, and with late lipid measurements. Conclusion Among HIV-infected women, hyperlipidemia is most strongly associated with subclinical atherosclerosis in treated women. Among treated women, the association appeared strongest early in the disease course.

Lipoprotein(a) and HIV

“…In a slightly older cohort of the WIHS (mean age: ~42 years), LDL-C and non-HDL-C levels were significantly and positively associated with cIMT in ART-treated HIV-infected women, but not in the untreated HIV-infected women. 35 Further, the significant association between these lipids and cIMT in the ART-treated HIV-infected women appeared to be weaker than those observed in the HIV-uninfected women. 35 Taken together, these findings indicate that the relationship of atherogenic and anti-atherogenic lipids with atherosclerotic processes in the HIV setting is a complex process and that the ability of these lipoproteins to predict cardiovascular risk may evolve over the course of HIV infection.…”

“…35 Further, the significant association between these lipids and cIMT in the ART-treated HIV-infected women appeared to be weaker than those observed in the HIV-uninfected women. 35 Taken together, these findings indicate that the relationship of atherogenic and anti-atherogenic lipids with atherosclerotic processes in the HIV setting is a complex process and that the ability of these lipoproteins to predict cardiovascular risk may evolve over the course of HIV infection. Evidence further indicates that atherosclerotic processes start in early childhood progressing with age and that this process begins even prematurely among HIV-infected children and young adults.…”

Review of Cardiovascular Disease in HIV-Infected Women

“…One study of 97 HIV-infected women noted that participants receiving protease inhibitors (PI) had increased CIMT compared to those not receiving PIs [18]. Another study found that in untreated HIV-infected women, there were no significant associations between lipid levels and CIMT, but in treated women higher levels of low-density lipoprotein cholesterol (LDL-c) and nonhigh density lipoprotein cholesterol (non-HDL-c) were associated with higher CIMT values [19]. Mangili et al found that significantly more HIV-infected women than men had metabolic syndrome, and the mean common CIMT measurement was significantly higher among participants with metabolic syndrome than among those without metabolic syndrome (0.66 mm vs. 0.59 mm; p=0.005) [20].…”

Perfil Metabólico De Portadores Do Hiv - Hospital De Clínicas De Curitiba

“…Além disso, como a TARV fez da infecção pelo HIV uma condição crônica, é importante considerar as comorbidades relacionadas ao avanço da idade que contribuem para o aumento do risco cardiovascular de portadores do vírus 10 . Com relação às mudanças do perfil metabólico, a infecção pelo HIV causa um desequilíbrio no metabolismo dos lipídios, caracterizado por baixos níveis de HDL-c, LDL-c e CT, e altos níveis de TG 1,5,6,11,12 . Após a introdução do IP, os níveis de HDL-c permanecem baixos e há aumento no CT, LDL-c e TG; enquanto que os regimes contendo ITRNN promovem aumento nas taxas de CT e LDL-c, e ainda, aumento concomitante dos níveis de HDL-c 13 .…”