Fenofibrate improves the atherogenic lipid profile and enhances LDL resistance to oxidation in HIV-positive adults.
BACKGROUND
Low HDL-cholesterol, hypertriglyceridemia (HTG) and occurrence of small dense LDL could be involved in increased cardiovascular risk in HIV-infected patients. This study evaluates the effects of fenofibrate and/or Vitamin E on lipoprotein profile.


METHODS
Thirty-six HIV-positive adults with fasting triglycerides (TGs) > or =2 mmol/l and stable antiretroviral therapy (ART) were randomly assigned to receive either micronised fenofibrate (200 mg/day) or Vitamin E (500 mg/day) for a first period of 3 months and the association of both for an additional 3-month period.


RESULTS
Total cholesterol, HDL-C, LDL-C, triglycerides, apoA1, apoB, apoCIII, lipoprotein composition, LDL size and LDL resistance to copper-induced oxidation were determined before initiation of fenofibrate or Vitamin E, and 3 and 6 months thereafter. Three months of fenofibrate treatment results in a significant decrease in triglycerides (-40%), apoCIII (-21%), total cholesterol (-14%), apoB (-17%) levels, non-HDL-C (-17%), TG/apoA1 ratio in HDL (-27%) associated with an increase in HDL-C (+15%) and apoA1 (+11%) levels. Moreover, fenofibrate increases LDL size and enhances LDL resistance to oxidation. Three months of Vitamin E supplementation only improves LDL resistance to oxidation and addition to fenofibrate results in a slightly greater effect.


CONCLUSIONS
Fenofibrate therapy improves the atherogenic lipid profile in HIV-positive adults with hypertriglyceridemia.
Badiou
Stephanie
S
Laboratoire de Biochimie des Lipides, Department of Biochemistry, 371 av du doyen Gaston Giraud, Hôpital Lapeyronie, CHU Montpellier F34295, France.
Merle De Boever
Corinne
C
Dupuy
Anne-Marie
AM
Baillat
Vincent
V
Cristol
Jean-Paul
JP
Reynes
Jacques
J
D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D016632:Apolipoprotein A-I / Q000097:blood; D053305:Apolipoprotein C-III; D001055:Apolipoproteins B; D001056:Apolipoproteins C / Q000097:blood; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003300:Copper / Q000494:pharmacology*; D005260:Female; D011345:Fenofibrate / Q000008:administration & dosage / Q000627:therapeutic use*; D015658:HIV Infections / Q000097:blood*; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood / Q000150:complications; D000960:Hypolipidemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D008074:Lipoproteins / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010084:Oxidation-Reduction / Q000187:drug effects; D014280:Triglycerides / Q000097:blood; D014810:Vitamin E / Q000008:administration & dosage / Q000627:therapeutic use
D044966:Anti-Retroviral Agents; D016632:Apolipoprotein A-I; D053305:Apolipoprotein C-III; D001055:Apolipoproteins B; D001056:Apolipoproteins C; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents; D008074:Lipoproteins; D008077:Lipoproteins, LDL; D014280:Triglycerides; D014810:Vitamin E; D003300:Copper; D002784:Cholesterol; D011345:Fenofibrate