Coronary artery calcification, atherogenic lipid changes, and increased erythrocyte volume in black injection drug users infected with human immunodeficiency virus-1 treated with protease inhibitors

Meng, Qinghua; Lima, João A.C.; Li, Hong; Vlahov, David; Celentano, David D.; Strathdee, Steffanie A.; Nelson, Kenrad E.; Wu, Kathérine C.; Chen, Shaoguang; Tong, Wing H.; Lai, Shenghan

doi:10.1067/mhj.2002.125009

Cited by 41 publications

(37 citation statements)

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“…[4][5][6]9,10,29,30 Therefore, the study of mechanisms involved in HAART-associated cardiovascular mortality may be relevant for the development of new drugs to treat HIV infection. In this study, we showed for the first time that HAART decreases the circulating levels of TIMP-1 by approximately 65%, thus increasing pro-MMP-9/TIMP-1 ratios by 34%.…”

Section: Discussionmentioning

confidence: 99%

A genetic polymorphism of matrix metalloproteinase 9 (MMP-9) affects the changes in circulating MMP-9 levels induced by highly active antiretroviral therapy in HIV patients

et al. 2009

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We examined whether two functional polymorphisms (g.À1562C4T and g.À90(CA)14-24) in the matrix metalloproteinase (MMP)-9 gene or MMP-9 haplotypes affect the circulating levels of pro-MMP-9 and pro-MMP-9/TIMP-1 (tissue inhibitor of metalloproteinase-1) ratios in AIDS patients, and modulate alterations in these biomarkers after highly active antiretroviral therapy (HAART). We studied 82 patients commencing HAART. Higher pro-MMP-9 concentrations and pro-MMP-9/TIMP-1 ratios were found in CT/TT patients compared with CC patients. HAART decreased pro-MMP-9 levels and pro-MMP-9/TIMP-1 ratios in CT/TT patients, it did not modify pro-MMP-9 levels and it increased pro-MMP-9/TIMP-1 ratios in CC patients. The g.À90(CA)14-24 polymorphism, however, produced no significant effects. Moreover, we found no significant differences in HAARTinduced changes in plasma pro-MMP-9, TIMP-1 and pro-MMP-9/TIMP-1 ratios when different MMP-9 haplotypes were compared. These findings suggest that the g.À1562C4T polymorphism affects pro-MMP-9 levels in patients with AIDS and modulates the alterations in pro-MMP-9 levels caused by HAART, thus possibly affecting the risk of cardiovascular complications.

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Section: Discussionmentioning

confidence: 99%

A genetic polymorphism of matrix metalloproteinase 9 (MMP-9) affects the changes in circulating MMP-9 levels induced by highly active antiretroviral therapy in HIV patients

et al. 2009

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“…Before widespread HAART use, elevated triglyceride and low HDL-C levels were reported in HIV infection [11,12]. In the HAART era, several studies have shown higher total cholesterol, LDL-C and triglyceride levels associated with PI use [6][7][8]. However, consistent with other investigators' findings of increased lipid levels even in patients on non-PI regimens, we found that non-PI HAART was associated with elevated levels of atherogenic lipoproteins similar to those seen with PI-based HAART [9,10].…”

Section: Discussionmentioning

confidence: 99%

“…However, several metabolic complications have been reported in association with HAART, including insulin resistance and dyslipidaemia [1][2][3][4][5]. There have been reports of high total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglyceride levels associated with protease inhibitor (PI) use [6][7][8]. High total cholesterol and triglyceride levels have also been reported in patients on non-PI HAART regimens [9,10].…”

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confidence: 99%

Increased serum lipids are associated with higher CD4 lymphocyte count in HIV‐infected women

Floris-Moore

Howard

et al. 2006

HIV Medicine

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ObjectiveHighly active antiretroviral therapy (HAART) has been associated with dyslipidaemia; however, the roles of immune status and non-HIV-disease risk factors remain unclear. MethodsA cross-sectional analysis of fasting lipids was carried out for 231 women, of whom 132 were HIVinfected and 99 were uninfected. The concentrations of total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, and apolipoprotein B (apo B) were measured. CD4 lymphocyte count, hepatitis C status, demographics, diet, and anthropometrics were also assessed. ResultsA total of 132 women were HIV-infected [30 were antiretroviral-naive, 68 were on protease inhibitors (PIs), and 34 were on non-PI HAART]. HIV infection was associated with higher triglycerides, lower HDL-C, and, among obese women, higher total cholesterol and LDL-C. Non-PI and PI HAART were each independently associated with higher total cholesterol, LDL-C, and apo B, compared with being ART-naive. Among HIV-infected women, after adjustment for HAART use, women with a CD4 lymphocyte count ! 500 cells/mL had total cholesterol 41.8 mg/dL (P 5 0.002) and LDL-C 28.8 mg/dL (P 5 0.01) higher, on average, than women with a CD4 count o200 cells/mL. Women with a CD4 count of 200-499 cells/mL had total cholesterol 26.31 mg/dL higher, on average, than those with a CD4 count o200 cells/mL (P 5 0.04), although differences in LDL-C did not reach significance (15.51 mg/dL; P 5 0.12). A higher CD4 count was also associated with higher apo B (Po0.001). Active hepatitis C infection was associated with lower total cholesterol, LDL-C, triglycerides, and apo B. ConclusionsHigher CD4 lymphocyte counts were associated with higher lipid levels, suggesting that immune competence may independently affect the dyslipidaemia seen in the HAART era. In addition, it is important that hepatitis C status be assessed in studies of dyslipidaemia in the HIV-infected population.Keywords: antiretroviral therapy, drug use, dyslipidaemia, women IntroductionHighly active antiretroviral therapy (HAART) has dramatically increased life expectancy among HIV-infected persons. However, several metabolic complications have been reported in association with HAART, including insulin resistance and dyslipidaemia [1][2][3][4][5]. There have been reports of high total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglyceride levels associated with protease inhibitor (PI) use [6][7][8]. High total cholesterol and triglyceride levels have also been reported in patients on non-PI HAART regimens [9,10]. In addition, low high-density lipoprotein (HDL-C) levels and hypertriglyceridaemia have been described in HIV-infected patients not receiving antiretroviral therapy [11][12][13]. 421Other factors, including dietary fat intake, physical activity, obesity, and genetics, may influence lipid levels [14][15][16]. Low levels of adiponectin, an adipocyte-derived peptide inversely related to insulin resistance and dyslipidaemia, have been reported in HIV-i...

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“…Los pacientes con factores de riesgo adicionales -como hipertensión, diabetes, tabaquismo e hiperhomocisteinemia-pueden tener un riesgo mayor para desarrollar síndromes coronarios agudos o infartos cerebrales, por la acelerada aterosclerosis que en ellos se produce (2,14,(17)(18)(19)(20)(21)(22) .…”

Section: Infarto Agudo De Miocardiounclassified

Patología cardiovascular en pacientes con infección por el virus de inmunodeficiencia humana

Valenzuela-Rodríguez

2013

An Fac med

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ResumenLa infección por el virus de inmunodeficiencia humana (VIH) estuvo asociada a un incremento de la morbimortalidad, dado que inducía un estado de inmunosupresión severa, la cual facilitaba la aparición de infecciones oportunistas. Sin embargo, posterior a la aparición y al uso de la terapia antirretroviral de gran actividad (TARGA), los pacientes infectados han experimentado una disminución de mortalidad asociada a infecciones, un incremento de la sobrevida y un incremento de enfermedades cardiovasculares. La etiología de estas enfermedades podría estar relacionada con la infección por sí misma, con condiciones proaterogénicas asociadas al empleo de determinados grupos de fármacos antirretrovirales, o con otros eventos adversos que estos serían capaces de inducir individualmente o al combinarse con otros medicamentos. Considerando que la mayoría de condiciones asociadas al compromiso cardiovascular en pacientes con VIH tiene inicio agudo, presentamos esta minuciosa revisión para reconocerlas en las salas de emergencia, eligiendo el tratamiento oportuno y excluyendo los tratamientos inapropiados. Palabras clave: Corazón, HIV, enfermedades cardiovasculares, síndrome de inmunodeficiencia adquirida. Abstract Human immunodeficiency virus (HIV) infection increases both morbidity and mortality by inducing severe immunosupression that generates opportunistic infections. Following use of high active antiretroviral therapy (HAART) in infected patients, infection-related mortality has decreased and both survival and cardiovascular disease have increased. The etiology of cardiovascular disease could be related to either infection itself, proatherogenic conditions associated with antiretroviral therapy or other adverse events caused by these therapies or by combination with other drugs. As most conditions associated with cardiovascular disease have an acute onset, we present this review for their recognition in the emergency ward, choosing opportune treatment and excluding inappropiate ones.

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Coronary artery calcification, atherogenic lipid changes, and increased erythrocyte volume in black injection drug users infected with human immunodeficiency virus-1 treated with protease inhibitors

Cited by 41 publications

References 38 publications

A genetic polymorphism of matrix metalloproteinase 9 (MMP-9) affects the changes in circulating MMP-9 levels induced by highly active antiretroviral therapy in HIV patients

A genetic polymorphism of matrix metalloproteinase 9 (MMP-9) affects the changes in circulating MMP-9 levels induced by highly active antiretroviral therapy in HIV patients

Increased serum lipids are associated with higher CD4 lymphocyte count in HIV‐infected women

Patología cardiovascular en pacientes con infección por el virus de inmunodeficiencia humana

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