Association of serum lipid levels with HIV serostatus, specific antiretroviral agents, and treatment regimens.
BACKGROUND
The effects of HIV infection, highly active antiretroviral therapy (HAART), and specific antiretroviral agents on lipoproteins in women are not well described.


METHODS
In a cross-sectional substudy of the Women's Interagency HIV Study with 623 HIV-negative and 1556 HIV-positive women (636 untreated, 419 on non-protease inhibitor [PI] HAART, and 501 on PI-containing HAART), we performed multivariate analyses of associations among fasting lipoprotein levels, HIV infection, and HAART.


RESULTS
Untreated HIV-positive women had lower high-density lipoprotein cholesterol (HDL-C) and higher triglycerides (TGs) but not lower low-density lipoprotein cholesterol (LDL-C) than HIV-negative women and were the most likely to have unfavorable HDL-C by National Cholesterol Education Program (NCEP) guidelines. PI HAART users had higher LDL-C than untreated HIV-infected women (107 vs. 100 mg/dL, P = 0.0006) and were the most likely to have unfavorable LDL-C and TGs by NCEP guidelines. HIV-negative women and non-PI HAART users had similar HDL-C levels (55 and 53 mg/dL, respectively), which were higher than those in untreated HIV-infected women and PI HAART users (42 and 49 mg/dL, respectively; P < 0.001 for all). Lamivudine, didanosine, nevirapine, and efavirenz were independently associated with higher HDL-C (P < 0.001 for all). Ritonavir, indinavir/ritonavir, and nelfinavir were associated with higher LDL-C (P < 0.01 for all). Stavudine, abacavir, and all ritonavir-containing regimens were associated with higher TGs (P < 0.05 for all), and tenofovir was associated with lower TGs (P = 0.009).


CONCLUSIONS
A dyslipidemic pattern was associated with HIV infection itself, was more severe in users of PI-containing HAART, but was not present in women taking non-PI HAART.
Anastos
Kathryn
K
Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10467, USA. kanastos@montefiore.org
Lu
Dalian
D
Shi
Qiuhu
Q
Tien
Phyllis C
PC
Kaplan
Robert C
RC
Hessol
Nancy A
NA
Cole
Steven
S
Vigen
Cheryl
C
Cohen
Mardge
M
Young
Mary
M
Justman
Jessica
J
D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D000328:Adult; D000480:Alkynes; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D048588:Benzoxazines / Q000009:adverse effects / Q000627:therapeutic use; D044383:Black People / Q000706:statistics & numerical data; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D003521:Cyclopropanes; D016049:Didanosine / Q000009:adverse effects / Q000627:therapeutic use; D015224:Dideoxynucleosides / Q000009:adverse effects / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005215:Fasting; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000378:metabolism; D017320:HIV Protease Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000188:drug therapy; D015497:HIV-1; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D019469:Indinavir / Q000009:adverse effects / Q000627:therapeutic use; D019259:Lamivudine / Q000009:adverse effects / Q000627:therapeutic use; D008055:Lipids / Q000097:blood*; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D015999:Multivariate Analysis; D019888:Nelfinavir / Q000009:adverse effects / Q000627:therapeutic use; D019829:Nevirapine / Q000009:adverse effects / Q000627:therapeutic use; D063065:Organophosphonates / Q000009:adverse effects / Q000627:therapeutic use; D019438:Ritonavir / Q000009:adverse effects / Q000627:therapeutic use; D018119:Stavudine / Q000009:adverse effects / Q000627:therapeutic use; D000068698:Tenofovir; D014280:Triglycerides / Q000097:blood; D014481:United States; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American; D000099227:Abacavir
D000225:Adenine; D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D002784:Cholesterol; D003521:Cyclopropanes; D016049:Didanosine; D015224:Dideoxynucleosides; D017320:HIV Protease Inhibitors; D019469:Indinavir; D019259:Lamivudine; D008055:Lipids; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D019888:Nelfinavir; D019829:Nevirapine; D063065:Organophosphonates; D019438:Ritonavir; D018119:Stavudine; D000068698:Tenofovir; D014280:Triglycerides; D000099227:Abacavir; C098320:efavirenz