Cardiovascular Disease-Risk Markers in HIV Patients
- *Corresponding Author:
- Bela F. Asztalos
JM-USDA/HNRCA at Tufts University
Lipid Metabolism Laboratory
711 Washington Street
Boston, MA 02111, USA
E-mail: [email protected]
Received Date: April 22, 2014; Accepted Date: June 02, 2014; Published Date: June 12, 2014
Citation: Asztalos BF, Matera R, Horvath KV, Horan M, Tani M, et al. (2014) Cardiovascular Disease-Risk Markers in HIV Patients. J AIDS Clin Res 5:317. doi:10.4172/2155-6113.1000317
Copyright: © 2014 Asztalos BF, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objectives: HIV-positive patients have an increased risk for CVD; however, the underlying mechanisms are not well understood. Our goal was to assess traditional and emerging CVD-risk factors in the CARE Study, a welldescribed cohort of HIV-infected adults.
Methods: We analyzed demographic and clinical (viral load, CD4 count, ART regimen, cIMT) data including markers of lipid and glucose homeostasis in 176 HIV-positive subjects receiving regular care for HIV infection.
Results: No significant association between cIMT and LDL-C level was observed. HIV patients had significantly lower level of the large α-1 HDL particles and about 3-fold higher level of the small pre β-1 HDL particles than the normal population, but these parameters were not significantly associated with cIMT. Components of the metabolic syndrome, high TG/low HDL-C, insulin resistance and high BMI, as well as viral load were significant but moderate contributors to increased cIMT.
Conclusion: The major lipid disorder was low HDL-C and high TG level in this HIV-positive cohort. LDL-C was not elevated. These and previously published data indicate that HIV infection and HIV medications influence CVD risk by impairing cholesterol removal (efflux) via ABCA1 from macrophages. Decreasing CVD risk in HIV patients, with impaired cholesterol efflux from macrophages, may require a lower LDL-C goal than recommended for HIV-negative patients and also a better control of TG level.