Impact of antiretroviral therapy on serum lipoprotein levels and dyslipidemias: A systematic review and meta-analysis

Nduka, Chidozie U.; Sarki, Ahmed; Uthman, Olalekan A.; Stranges, Saverio

doi:10.1016/j.ijcard.2015.07.052

Cited by 35 publications

(32 citation statements)

References 56 publications

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“…De acuerdo a nuestro estudio, la probabilidad de tener dislipidemia es mayor en pacientes mayores a 40 años, lo cual coincide con reportes en población general, en quienes el riesgo de dislipidemia y de enfermedad cardiovascular se incrementa con la edad (8) . En cuanto al tiempo en TARGA y la presencia de dislipidemia, un metaanálisis no encontró asociación significativa entre ambas variables, al igual que este estudio (19) .…”

Section: Discussionunclassified

Elevada frecuencia de dislipidemia en pacientes infectados por VIH en un hospital público peruano

Taype‐Rondan

Flores-Flores

Doria

et al. 2017

Rev Peru Med Exp Salud Publica

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RESUMENEl objetivo del estudio fue determinar la frecuencia y características de la dislipidemia en pacientes con VIH en terapia antirretroviral de gran actividad (TARGA) en un hospital público peruano. Se realizó un estudio transversal en pacientes que tuvieran un perfil lipídico completo luego de recibir al menos seis meses de TARGA. La dislipidemia se definió según los criterios NCEP-ATP III. Se revisaron 2975 historias clínicas, 538 (18.1%) fueron incluidas en el análisis. La frecuencia de dislipidemia fue 74.7%. Los esquemas de TARGA que incluían inhibidores de la proteasa (IP) (OR 1.22; IC95% 1,11-1,34) y la edad mayor de 40 años (OR 1.17; IC95% 1,06-1,29) mostraron asociación con dislipidemia, ajustado por carga viral, nivel de células CD4 y sexo. En conclusión, la dislipidemia fue muy frecuente en la muestra estudiada y estuvo asociada principalmente al uso de IP. Es necesario promover el control de la dislipidemia como parte de la atención integral del paciente con infección por VIH. Palabras clave: Dislipidemias; VIH; Terapia antirretroviral altamente activa (fuente: DeCS BIREME). HIGH FREQUENCY OF DYSLIPIDEMIA IN HIV-INFECTED PATIENTS IN A PERUVIAN PUBLIC HOSPITAL ABSTRACTThe objective of the study was to determine the frequency and characteristics of dyslipidemia in patients with HIV in highly active antiretroviral therapy (HAART) in a Peruvian public hospital. A cross-sectional study was carried out in patients with complete lipid profile after receiving at least six months of HAART. Dyslipidemia was defined according to the criteria of the NCEP-ATP III. We reviewed 2 975 clinical histories, and included 538 (18.1%) in the analysis. The frequency of dyslipidemia was 74.7%. HAART regimens which include protease inhibitors (PI) (odds ratio [OR]: 1.22; confidence interval at 95% [CI 95%]: 1.11-1.33) and to be older than 40 years (OR: 1.17; CI 95%: 1.05-1.28) were associated with dyslipidemia, adjusted by viral load, CD4 lymphocyte level and gender. In conclusion, dyslipidemia was very common in our sample and was mainly associated with the use of PI. It is necessary to promote the dyslipidemia control as part of the comprehensive care of the patient with HIV.

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Section: Discussionunclassified

Elevada frecuencia de dislipidemia en pacientes infectados por VIH en un hospital público peruano

Taype‐Rondan

Flores-Flores

Doria

et al. 2017

Rev Peru Med Exp Salud Publica

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“…Baseline socio-demographic characteristics, risk factors and clinical and laboratory findings by ART status Table 1 summarises the baseline socio-demographic characteristics, risk factors and clinical and laboratory findings of the cohort stratified by ART status. In total, 495 HIV-infected adults were enrolled; 474 (95.76%) were receiving ART (ART-exposed patients) and 21 (4.24%) were not on ART (ART-unexposed patients or newly diagnosed patients; Figure 1 The median [IQR] duration on ART was 5 years [2][3][4][5][6][7][8]. Four hundred and fifty-five (90.8%) and 46 (9.2%) of participants were on first-line NNRTI (efavirenz or nevirapine)-or second-line PI (LPV/r)-based ART regimens, respectively.…”

Section: Resultsmentioning

confidence: 99%

Prevalence and risk factors of metabolic syndrome in HIV‐infected adults at three urban clinics in a post‐conflict setting, eastern Democratic Republic of the Congo

Katoto

Thienemann

Bulabula

et al. 2018

Tropical Med Int Health

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“…1–3 Infection with HIV causes persistent immune activation associated with CD4+ T-cell loss, HIV RNA viral load, and disease progression, as well as a number of significant anthropometric and metabolic alterations, including dyslipidemia. 19 While HIV/ART-induced modifications in lipids and lipoproteins and their relationships with CVD have been investigated previously, 20 documentation of any role of plasma Lp(a) level and genetic variability in the apo(a) gene (e.g., a size polymorphism) in HIV-related elevated CVD risk is lacking. A small longitudinal study reported an increase in Lp(a) level from baseline among protease inhibitor treated HIV-infected individuals 21 .…”

Section: Discussionmentioning

confidence: 99%

Lipoprotein(a) and HIV

Enkhmaa

Anuurad

Zhang

et al. 2017

ATVB

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Objective In the general population, lipoprotein(a), Lp(a), has been established as an independent causal risk factor for cardiovascular disease (CVD). Lp(a) levels are to a major extent regulated by a size polymorphism in the apolipoprotein(a), apo(a), gene. The roles of Lp(a)/apo(a) in HIV-related elevated CVD risk remain unclear. Approach and Results The associations between total plasma Lp(a) level, allele-specific apo(a) level, an Lp(a) level carried by individual apo(a) alleles, and common carotid artery intima-media thickness (cIMT) were assessed in 150 HIV-infected and 100 HIV-uninfected women in the Women’s Interagency HIV Study. Linear regression analyses with and without adjustments were used. The cohort was young (mean age: ~31 years) with the majority being African-Americans (~70%). The prevalence of a small size apo(a) (≤22 Kringle repeats) or a high Lp(a) level (≥30 mg/dL) was similar by HIV status. Total plasma Lp(a) level (p=0.029) and allele-specific apo(a) level carried by the smaller apo(a) sizes (p=0.022) were significantly associated with cIMT in the HIV-infected women only. After accounting for confounders (age, race, smoking, BMI, blood pressure, HCV co-infection, menopause, plasma lipids, treatment status, CD4+ T-cell count, and HIV/RNA viral load), the association remained significant for both Lp(a) (p=0.035) and allele-specific apo(a) level carried by the smaller apo(a) sizes (p=0.010) in the HIV-infected women. Notably, none of the other lipids/lipoproteins was associated with cIMT. Conclusions Lp(a) and allele-specific apo(a) levels predict cIMT in HIV-infected young women. Further research is needed to identify underlying mechanisms of an increased Lp(a) atherogenicity in HIV infection.

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Impact of antiretroviral therapy on serum lipoprotein levels and dyslipidemias: A systematic review and meta-analysis

Cited by 35 publications

References 56 publications

Elevada frecuencia de dislipidemia en pacientes infectados por VIH en un hospital público peruano

Elevada frecuencia de dislipidemia en pacientes infectados por VIH en un hospital público peruano

Prevalence and risk factors of metabolic syndrome in HIV‐infected adults at three urban clinics in a post‐conflict setting, eastern Democratic Republic of the Congo

Lipoprotein(a) and HIV

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