Postprandial lipoprotein changes in patients taking antiretroviral therapy for HIV infection.
OBJECTIVE
Dyslipidemia is common among patients receiving antiretroviral therapy for HIV infection. The purpose of this study was to determine whether postprandial lipemia contributes to the dyslipidemia observed in HIV-positive patients taking antiretroviral therapy.


RESULTS
A standardized fat load was administered to 65 subjects (group 1 35 HIV-positive subjects receiving protease inhibitors [PIs]; group 2 20 HIV-positive subjects not receiving PIs; group 3 10 HIV-negative controls). Serum triglycerides, retinyl palmitate, and lipoproteins were measured using enzymatic and nuclear magnetic resonance spectroscopic techniques. Compared with HIV-negative controls, peak postprandial retinyl palmitate and large very low-density lipoprotein (VLDL) levels occurred later in both HIV-positive groups, and a delayed decrease in serum triglycerides was observed. However, postprandial areas under the curve (AUCs) for triglycerides, retinyl palmitate, chylomicrons, and large VLDL were similar. Postprandial AUCs for intermediate-density lipoproteins (IDLs) and low-density lipoproteins (LDLs) were higher in group 1 than groups 2 and 3 (all P<0.035).


CONCLUSIONS
Postprandial clearance of triglyceride-rich lipoproteins is delayed in HIV-positive individuals receiving antiretroviral therapy. Compared with HIV-positive individuals not on PIs, those taking PIs do not have increased postprandial triglyceride-rich lipoproteins but do have increased postprandial IDLs and LDLs. An oral fat load was administered to 55 HIV-positive and 10 HIV-negative individuals. Postprandial clearance of triglyceride-rich lipoproteins was delayed in HIV-positive individuals. Compared with HIV-positive subjects not on PIs, those taking PIs do not have increased postprandial triglyceride-rich lipoproteins but do have increased postprandial intermediate-density and low-density lipoproteins.
Stein
James H
JH
University of Wisconsin Medical School, 600 Highland Ave, G7/341 CSC (MC 3248) Madison, WI 53792, USA. jhs@medicine.wisc.edu
Merwood
Michelle A
MA
Bellehumeur
Jennifer B
JB
McBride
Patrick E
PE
Wiebe
Donald A
DA
Sosman
James M
JM
D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D001057:Apolipoproteins E / Q000097:blood / Q000235:genetics; D019540:Area Under Curve; D001786:Blood Glucose / Q000032:analysis; D002914:Chylomicrons / Q000097:blood; D003327:Coronary Disease / Q000453:epidemiology; D004041:Dietary Fats / Q000008:administration & dosage*; D004224:Diterpenes; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000139:chemically induced*; D006973:Hypertension / Q000453:epidemiology; D007328:Insulin / Q000097:blood; D008074:Lipoproteins / Q000097:blood*; D053419:Lipoproteins, IDL; D008077:Lipoproteins, LDL / Q000097:blood; D008079:Lipoproteins, VLDL / Q000097:blood; D008297:Male; D019518:Postprandial Period; D000084562:Retinyl Esters; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood; D014801:Vitamin A / Q000031:analogs & derivatives* / Q000097:blood
D019380:Anti-HIV Agents; D001057:Apolipoproteins E; D001786:Blood Glucose; D002914:Chylomicrons; D004041:Dietary Fats; D004224:Diterpenes; D017320:HIV Protease Inhibitors; D007328:Insulin; D008074:Lipoproteins; D053419:Lipoproteins, IDL; D008077:Lipoproteins, LDL; D008079:Lipoproteins, VLDL; D000084562:Retinyl Esters; D014280:Triglycerides; D014801:Vitamin A; C014794:retinol palmitate