Metabolic changes associated with antiretroviral therapy in HIV-positive patients.
OBJECTIVE
To evaluate metabolic changes associated with highly active antiretroviral therapy (HAART) in HIV-positive patients, and to identify risk factors associated.


METHODS
Retrospective study that included 110 HIV-positive patients who where on HAART in the city of Porto Alegre (Southern Brazil) between January 2003 and March 2004. Data on demographic variables, cigarette smoking, diabetes mellitus, cholesterol and triglyceride levels, stage of HIV infection, antiretroviral therapy and HCV coinfection were collected. General linear models procedure for repeated measures was used to test the interaction between HAART and HCV coinfection or protease inhibitor treatment.


RESULTS
Total cholesterol, triglycerides, and glucose levels significantly increased after receiving HAART (p<0.001 for all variables), but no interaction with protease inhibitors was seen for total cholesterol, glucose and triglyceride levels (interaction treatment*protease inhibitors p=0.741, p=0.784, and p=0.081, respectively). An association between total cholesterol levels and HCV coinfection was found both at baseline and follow-up (effect of HCV coinfection, p=0.011). Glucose levels were increased by HAART (treatment effect, p=0.036), but the effect was associated to HCV coinfection (treatment*HCV effect, p=0.018). Gender, smoking habit, intravenous drug use and age were not significantly associated with cholesterol, triglyceride and glucose changes.


CONCLUSIONS
HCV-infected patients at baseline were significantly less likely to develop hypercholesterolemia. The results provide further evidence of the role of HAART for the development of metabolic disturbances.
Almeida
Sabrina Esteves de Matos
SE
Centro de Desenvolvimento Científico e Tecnológico, Fundação Estadual de Produção e Pesquisa em Saúde, Porto Alegre, RS, Brazil. sabrina.gene@gmail.com
Borges
Michele
M
Fiegenbaum
Marilu
M
Nunes
Cynara Carvalho
CC
Rossetti
Maria Lucia Rosa
ML
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D018791:CD4 Lymphocyte Count; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D050171:Dyslipidemias / Q000097:blood / Q000139:chemically induced*; D005260:Female; D005947:Glucose / Q000032:analysis*; D015658:HIV Infections / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D006526:Hepatitis C / Q000097:blood / Q000150:complications*; D006801:Humans; D008297:Male; D011480:Protease Inhibitors / Q000627:therapeutic use; D012367:RNA, Viral; D012189:Retrospective Studies; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
D019380:Anti-HIV Agents; D011480:Protease Inhibitors; D012367:RNA, Viral; D014280:Triglycerides; D002784:Cholesterol; D005947:Glucose