Lipoprotein particle subclasses, cardiovascular disease and HIV infection.
OBJECTIVE
To study the association of lipoprotein particles with CVD in a subgroup of HIV-infected patients who were enrolled in the Strategies for Management of Anti-Retroviral Therapy (SMART) study. SMART was a trial of intermittent use of ART (drug conservation [DC]) versus continuous of ART (viral suppression [VS]).


METHODS
In a nested case-control study, lipoprotein particles (p) by nuclear magnetic resonance were measured at baseline and at the visit prior to the CVD event (latest levels) for 248 patients who had a CVD event and for 480 matched controls. Odds ratios (ORs) were estimated using conditional logistic models.


RESULTS
Total, large and small HDL-p, but not VLDL-p nor LDL-p, were significantly and inversely associated with CVD and its major component, non-fatal coronary heart disease. The HDL-p associations with CVD were reduced after adjustment for high sensitive C-reactive protein (hsCRP), interleukin-6 (IL-6) and D-dimer. Latest levels of total HDL-p were also significantly inversely associated with CVD; treatment interruption led to decrease of total HDL-p; adjusting for latest HDL-p did not explain the greater risk of CVD that was observed in the DC versus VS group.


CONCLUSIONS
Lipoprotein particles, especially lower levels of small and large HDL-p identify HIV-infected patients at increased risk of CVD independent of other CVD risk factors.
Duprez
Daniel A
DA
Cardiovascular Division, University of Minnesota, Minneapolis, MN 55455, USA. dupre007@umn.edu
Kuller
Lewis H
LH
Tracy
Russell
R
Otvos
James
J
Cooper
David A
DA
Hoy
Jennifer
J
Neuhaus
Jacqueline
J
Paton
Nicholas I
NI
Friis-Moller
Nina
N
Lampe
Fiona
F
Liappis
Angelike P
AP
Neaton
James D
JD
D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D016022:Case-Control Studies; D004334:Drug Administration Schedule; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019906:Nuclear Magnetic Resonance, Biomolecular; D016017:Odds Ratio; D010316:Particle Size; D018570:Risk Assessment; D012307:Risk Factors
D044966:Anti-Retroviral Agents; D015415:Biomarkers; D008075:Lipoproteins, HDL