Alterations in lipid profiles in HIV-infected patients treated with protease inhibitor therapy are not influenced by diet.
BACKGROUND
The use of protease inhibitor (PI) -based highly active antiretroviral therapy (HAART) in patients infected with human immunodeficiency virus (HIV) has been linked to alterations in lipid profiles.


METHODS
Longitudinal cohort study. Lipid profiles were evaluated pre- and post-PI therapy in 49 HIV-infected patients. Diet was also evaluated to determine any contribution to alterations in lipid levels.


RESULTS
Pre- and post-PI-based HAART samples were examined from 42 men and 7 women, mean age 40.6 years. Mean CD4 count pre-PI was 242 +/- 205 cells/mm(3); HIV RNA was 4.2 log(10) copies/mL; body mass index (BMI) was 24.7 +/- 3.6 kg/m(2); body fat was 17.1 +/- 9.1 kg by bioelectrical impedance analysis (BIA), dietary intake was 2654 +/- 732 kcal/day. Post-PI samples were collected 5.7 +/- 1.66 months after starting therapy. CD4 counts increased to 384 +/- 323 cells/mm(3) and RNA decreased 1 log post-PI. Post-PI BMI (25.2 kg/m2), percent body fat (17.4%) and caloric intake (2656 kcal/day) were unchanged. Pre-PI total cholesterol (TC) in men was 167.6 +/- 42.4 mg/dL; TC increased (190.4 +/- 47.9 mg/dL) post-PI (p < .0001). Pre-PI triglycerides (TG) were 154.5 +/- 109.4 mg/dL; TG increased post-PI (266.1 +/- 363.6 mg/dL, p < .03). Low-density lipoprotein (LDL) -C was 97.8 +/- 31 mg/dL pre-PI and rose to 107.1 +/- 34.7 mg/dL post-PI (p < .05). High density lipoproteins (HDLs) were below desired levels before initiation of PI therapy and remained low.


CONCLUSIONS
PI therapy significantly alters lipid profiles in HIV-infected patients. Dietary intake did not contribute to changes in lipid profile. More longitudinal studies are needed to demonstrate whether these alterations contribute to additional cardiovascular risk.
Wanke
Christine
C
Department of Public Health and Nutrition Infection Unit, Tufts University School of Medicine, Boston, MA 02111, USA. christine.wanke@tufts.edu
Gerrior
Jül
J
Hendricks
Kristy
K
McNamara
Judith
J
Schaefer
Ernest
E
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D015992:Body Mass Index; D018791:CD4 Lymphocyte Count / Q000706:statistics & numerical data; D015331:Cohort Studies; D004032:Diet / Q000379:methods*; D017097:Electric Impedance; D002149:Energy Intake / Q000187:drug effects; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000188:drug therapy*; D006801:Humans; D008055:Lipids / Q000097:blood*; D008137:Longitudinal Studies; D008297:Male; D011480:Protease Inhibitors / Q000627:therapeutic use*; D012313:RNA / Q000097:blood / Q000187:drug effects; D012885:Skinfold Thickness
D008055:Lipids; D011480:Protease Inhibitors; D012313:RNA