Abstract

Combination antiretroviral therapy and the risk of lipid disorders in HIV-infected adults

E.M. Linares Guerra

Facultad de Ciencias Médicas, Ciencias Fisiológicas, Pinar del Río, Cuba

Background: In Cuba, like in other countries, the use of new and combined antiretroviral therapies substantially improves survival and quality of life of people with HIV/AIDS. However, its long-term effects may involve a risk of cardiovascular disease. The objective of the present investigation was to assess the risk of lipid disorders in people with HIV/AIDS using antiretroviral therapy and how it is related to the time of exposure to the drugs.
Methods: An observational, analytic and transversal study was conducted in 152 individuals, 98 of them without antiretroviral therapy and 54 with it. In all studied individuals the following determinations were carried out: triglycerides, total cholesterol, very-low-density lipoprotein cholesterol (VLDL-c), high-density lipoprotein cholesterol (HDL-c) and low-density lipoprotein cholesterol (LDL-c). The serum levels of lipids and lipoproteins were connected to the time of exposure to antiretrovirals. A comparison of mean values was made using the test for two independent samples. Different variances were assumed. The association of quantitative variables was studied through linear correlation analysis. All comparisons were performed with 95% certainty.
Results: No differences were found in the mean values obtained for serum levels of HDL-c and LDL-c as both groups were compared, whereas the levels of triglycerides, cholesterol and VLDL-c increased significantly in people with HIV/AIDS who used antiretrovirals (p < 0, 01). The frequency of individuals with altered serum levels of triglycerides, VLDL-c and HDL-c increased significantly with the time of exposure to the drugs (p< 0, 01).
Conclusions: Our results contribute to the growing body of evidence implicating antiretroviral therapy in the development of blood lipid abnormalities. The elevated frequency of individuals with hypertriglyceridemia and diminished HDL-c, may mean that patients such as these are at elevated risk for cardiovascular events in the future.
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