Influence of hepatitis C genotypes on lipid levels in HIV-positive patients during highly active antiretroviral therapy.
BACKGROUND
The independent role of HCV genotype 3 (HCV-3) in dyslipidaemia following highly active antiretroviral therapy (HAART) is still unexplored.


METHODS
Analysis of data from a cohort of 307 HIV/HCV-coinfected patients and 415 HIV-monoinfected controls was conducted. Patients with available lipid levels at baseline and minimum 3-month follow-up were ranked into three groups by HCV status (HCV-3, other HCV genotypes or HCV negative). Univariate and multivariate GEE models were performed to assess factors correlated with lipid serum levels as coefficient (Coef., defined as mean difference [mg/dl] across the follow-up). Univariate and multivariate logistic regression analyses were performed for prediction of relevant hypertriglyceridaemia (> or = 500 mg/dl) and relevant hypercholesterolaemia (> or = 240mg/dl) at 3 months of follow-up.


RESULTS
HCV-3 correlated with lower triglyceridaemia (Coef.=-38.22; P=0.001), independently from the other considered variables, including age, gender and use of stavudine or lopinavir. Even though HCV infection per se appeared to be protective, HCV-3 in particular was also independently associated with lower cholesterolaemia (Coef.=-46.35; P<0.001). At logistic regression analyses, HCV-3, but not HCV-non-3, was associated with lower risk of relevant hypercholesterolaemia (odds ratio [OR] 0.06; P=0.01) and relevant hypertriglyceridaemia (OR 0.11; P=0.05), independently from other considered variables.


CONCLUSIONS
Our data confirm that HCV coinfection per se is associated with lower risk of hypercholesterolaemia after HAART. This effect was particularly attributed to HCV-3, which was the only genotype associated with lower triglyceridaemia during HAART.
Lapadula
Giuseppe
G
Istituto per le Malattie Infettive e Tropicali, Università di Brescia, Brescia, Italy.
Torti
Carlo
C
Paraninfo
Giuseppe
G
Castelnuovo
Filippo
F
Uccelli
Maria Cristina
MC
Costarelli
Silvia
S
Ladisa
Nicoletta
N
Maserati
Renato
R
Di Pietro
Massimo
M
De Silvestri
Annalisa
A
Tinelli
Carmine
C
Puoti
Massimo
M
Carosi
Giampiero
G
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D002784:Cholesterol / Q000097:blood*; D005838:Genotype; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D015497:HIV-1; D016174:Hepacivirus / Q000145:classification* / Q000235:genetics; D006526:Hepatitis C / Q000150:complications / Q000821:virology*; D006801:Humans; D014280:Triglycerides / Q000097:blood*
D014280:Triglycerides; D002784:Cholesterol