title: Atherogen lipid profile in HIV-1-infected patients with lipodystrophy syndrome.
abstract: Background: Cases of lipodystrophy syndrome and metabolic disorders have been described since the onset of highly active antiretroviral therapy in HIV-infected patients. The aim of our study was to estimate the prevalence of lipodystrophy (LD) and to define the associated lipid profile of these patients. Methods: The following were determined for each patient: lipid profile (cholesterol and its subfractions, atherogenicity ratios, and triglycerides), blood glucose, and immunovirological markers (CD4(+) cell count and plasma viral load). Patients were classified into two groups on the basis of whether or not they presented with clinical signs of LD. Results: Among 233 HIV-infected patients included in the study, 61 cases (26.1%) of lipodystrophy (LD) were noted. Compared with non-LD patients (NLD), LD patients were older men (P<10(-4)) with a lower CD4(+) lymphocyte cell count (P<0.007) and more often at the AIDS stage (P<10(-3)) (OR=3.2 (95% CI: 1.47-6.2)). Multivariate analysis showed a correlation between LD cases and age (10 years older) (OR=1.78 (95% CI: 1.23-2.57), P<0.002) and the decrease in CD4(+) cell count (100 CD4(+)/mm(3) lower) (OR=1.31 (95% CI: 1.09-1.58), P<0.004). An analysis of lipid subfractions and atherogenicity ratios clearly indicated a proatherogenic lipid profile for the LD patients. Conclusions: The underlying physiopathological mechanism of LD is still unknown. However, the lipid profile of HIV-1-infected patients with a LD syndrome appears to place these patients at an increased risk of progression of atherosclerosis.
authors.affiliation: Clinique de Médecine Interne et Maladies Infectieuses, Hôpital Haut Lévêque, Centre Hospitalier Universitaire de Bordeaux, 33604, Pessac, France
authors.initials: P
authors.lastname: Mercié
authors.initials: S
authors.lastname: Tchamgoué
authors.initials: R
authors.lastname: Thiébaut
authors.initials: J
authors.lastname: Viallard
authors.initials: I
authors.lastname: Faure
authors.initials: V
authors.lastname: Dancourt
authors.initials: C
authors.lastname: Marimoutou
authors.initials: F
authors.lastname: Dabis
authors.initials: P
authors.lastname: Rispal
authors.initials: Y
authors.lastname: Darmon
authors.initials: B
authors.lastname: Leng
authors.initials: J
authors.lastname: Pellegrin