HIV-associated dyslipidaemia: pathogenesis and treatment

Oh, Jisun; Hegele, Robert A.

doi:10.1016/s1473-3099(07)70287-6

Cited by 107 publications

(72 citation statements)

References 132 publications

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“…A particularity of dyslipidemia in HIV+ patients treated by c-ART is the combination of lipid disturbances related firstly to the HIV infection per se and secondly induced by c-ART. Management of this complex dyslipidemia appears as an important challenge for clinicians, as often, lipid lowering therapy alone does not allow to reach the lipid target 36,41,42 and should be associated to diet and lifestyle modification and/or switching of some antiretroviral agents 43 . A specific disturbance that persists in about half of patients is a trend to low HDL-C levels and moderate hypertriglyceridemia.…”

Section: Discussionmentioning

confidence: 99%

Association of non-HDL cholesterol with subclinical atherosclerosis in HIV-positive patients

Badiou

Thiébaut

Aurillac-Lavignolle

et al. 2008

Journal of Infection

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Section: Discussionmentioning

confidence: 99%

Association of non-HDL cholesterol with subclinical atherosclerosis in HIV-positive patients

Badiou

Thiébaut

Aurillac-Lavignolle

et al. 2008

Journal of Infection

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“…It is hypothesised that this dyslipidaemia is multifactorial and includes a direct effect of the PI and a more complex mechanism involveing immunologic, genetic and pharmacodynamic factors and HIV-infection itself [5,12,16,17,24]. To our knowledge this is the first prospective study analysing LPV levels with serum lipids in a cohort of only antiretroviral therapy-naive patients.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with initially high lipid levels are at higher risk of developing (severe) hyperlipidaemia. The pathogenic mechanism of this dyslipidaemia is multifactorial and includes effects of the virus itself and antiretroviral use [5].…”

Section: Introductionmentioning

confidence: 99%

Lopinavir Plasma Concentrations and Serum Lipids in Therapy Naïve HIV-Patients: A Sub Analysis of the FREE Study

Hofstede¹,

Koopmans²,

Burger³

et al. 2012

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Antiretroviral therapy in HIV patients is known for its negative effect on the cardiovascular system. One of the major adverse events in patients on lopinavir is increasing lipids. Hyperlipidaemia together with chronic inflammation by HIV-infection itself makes these patients prone for cardiovascular diseases.The purpose of this study (a sub study within the FREE-study) was to determine if higher plasma lopinavir (LPV) concentrations lead to increase of serum lipids. Plasma drug concentrations were analysed up to week 24 in a prospective cohort of HIV antiretroviral therapy naive patients who started on a regimen of zidovudine, lamivudine and ritonavir-boosted lopinavir (FREE study). Prospectively we measured plasma lopinavir concentrations from baseline to week 24 in 72 naive HIV-patients starting on lopinavir (59 males and 13 females). A total of 210 samples were analysed, with at least 2 samples in every patient. Mean LPV trough concentration was 4.3 mg/L (± 2.1). The median intra-subject variation in LPV level was 38% (range 4% -111%). Serum lipids were not correlated to LPV plasma concentrations possibly due to the wide intra-individual variability in LPV trough levels. Monitoring of plasma lopinavir and subsequent dose adjustment of LPV will not be useful to prevent hyperlipidaemia in HIV-patients treated with lopinavir.

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“…17,18 There is thus a persistent inflammatory state in these patients that results in vascular damage and premature atherosclerosis. 19 Some studies have shown a significant increase in non-calcified plaques in HIV patients treated with HAART, which may also be associated with cardiovascular events.…”

Section: Hiv and The Pathophysiology Of Cardiovascular Diseasementioning

confidence: 99%

HIV and coronary disease – When secondary prevention is insufficient

Carvalho

Valente

Morais

et al. 2017

Revista Portuguesa de Cardiologia (English Edition)

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Highly active antiretroviral therapy (HAART) has created a new paradigm for human immunodeficiency virus (HIV)-infected patients, but their increased risk for coronary disease is well documented.We present the case of a 57-year-old man, co-infected with HIV-2 and hepatitis B virus, adequately controlled and with insulin-treated type 2 diabetes and dyslipidemia, who was admitted with non-ST elevation acute myocardial infarction. Coronary angiography performed on day four of hospital stay documented two-vessel disease (mid segment of the right coronary artery [RCA, 90% stenosis] and the first marginal). Tw o drug-eluting stents were successfully implanted. The patient was discharged under dual antiplatelet therapy (aspirin 100 mg/day and clopidogrel 75 mg/day) and standard coronary artery disease medication. He was admitted to the emergency room four hours after discharge with chest pain radiating to the left arm and inferior ST-segment elevation myocardial infarction was diagnosed. Coronary angiography was performed within one hour and documented thrombosis of both stents. Optical coherence tomography revealed good apposition of the stent in the RCA, with intrastent thrombus. Angioplasty was performed, with a good outcome.The acute stent thrombosis might be explained by the thrombotic potential of HIV infection and diabetes. There are no specific guidelines regarding HAART in secondary prevention of acute coronary syndromes. A multidisciplinary approach is essential for optimal management of these patients. © 2017 Sociedade Portuguesa de Cardiologia. Published by Elsevier España, S.L.U. All rights reserved. Document downloaded from http://www.elsevier.es, day 24/08/2017. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited. Document downloaded from http://www.elsevier.es, day 24/08/2017. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited. 569.e2A.S. Carvalho et al. PALAVRAS-CHAVEVírus da imunodeficiência humana; Trombose de stent; Doença coronária VIH e doença coronária ---quando a prevenção secundária é insuficienteResumo A terapêutica antiretroviral (TARV) alterou o paradigma da infeção pelo vírus da imunodeficiência humana (VIH), conhecendo-se o risco aumentado de doença coronária nestes doentes.Apresenta-se o caso de um homem de 57 anos, melanodérmico, com coinfecção VIH-2/vírus hepatite B, com controlo adequado; diabetes mellitus tipo 2, insulino-tratado e dislipidemia. Internado por enfarte agudo do miocárdio, sem supradesnivelamento ST. Realizou cateterismo ao 4.• dia de internamento, documentando-se doença de dois vasos (segmento médio da coronária direita [CD] [90% estenose] e 1. a obtusa marginal [OM1] com estenose de 95%). Colocaram-se dois stents revestidos, sem intercorrências. Teve alta sob dupla antiagregação (ácido acetilsalicílico 100 mg/dia e clopidogrel 75 mg/dia) e restante terapêutica dirigida à doença coronária. Recorreu ao serviço de urgência quatro horas após a alt...

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HIV-associated dyslipidaemia: pathogenesis and treatment

Cited by 107 publications

References 132 publications

Association of non-HDL cholesterol with subclinical atherosclerosis in HIV-positive patients

Association of non-HDL cholesterol with subclinical atherosclerosis in HIV-positive patients

Lopinavir Plasma Concentrations and Serum Lipids in Therapy Naïve HIV-Patients: A Sub Analysis of the FREE Study

HIV and coronary disease – When secondary prevention is insufficient

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HIV-associated dyslipidaemia: pathogenesis and treatment

Cited by 107 publications

References 132 publications

Association of non-HDL cholesterol with subclinical atherosclerosis in HIV-positive patients

Association of non-HDL cholesterol with subclinical atherosclerosis in HIV-positive patients

Lopinavir Plasma Concentrations and Serum Lipids in Therapy Na&#239;ve HIV-Patients: A Sub Analysis of the FREE Study

HIV and coronary disease – When secondary prevention is insufficient

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Product

Resources

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Lopinavir Plasma Concentrations and Serum Lipids in Therapy Naïve HIV-Patients: A Sub Analysis of the FREE Study