HIV, HAART, and lipoprotein particle concentrations in the Women's Interagency HIV Study.
BACKGROUND
Changes in lipoprotein particle concentrations, especially greater small low-density lipoprotein particle (LDL-p) and lower small high-density lipoprotein particle (HDL-p) may provide information regarding cardiovascular disease (CVD) risk above and beyond that which is provided by standard lipids. We quantified the association HIV and HAART use had with LDL-p and HDL-p.


METHODS
Cross-sectional study of 1077 individuals classified by HIV/HAART status (361 HIV-uninfected, 128 HIV-infected/HAART naive, 588 HIV-infected/on HAART) enrolled in the Women's Interagency HIV Study. Nuclear magnetic resonance spectroscopy estimated total and subclass lipoprotein particle concentrations. Quantile regression models were used to estimate differences in the 10th, 25th, 50th, 75th, and 90th percentiles of the distributions of lipoprotein particle concentrations between the two HIV-infected exposure groups and HIV-uninfected controls after adjustment for demographic, nonlipid metabolic factors, and standard lipids.


RESULTS
Compared with HIV-uninfected women, those on HAART had greater 75th and 90th percentiles of small LDL-p; there was little difference between HIV-infected/HAART naive and HIV-uninfected women. After adjustment for triglycerides, the association of HAART with greater 75th and 90th percentiles of small LDL-p was attenuated and no longer significant. In contrast, after adjustment for triglycerides, HIV infection irrespective of HAART status remained associated with significantly lower 10th, 25th, 50th, 75th, and 90th percentiles of small HDL-p.


CONCLUSIONS
Our findings suggest that testing for LDL-p confers little additional information beyond triglycerides levels when assessing CVD risk. Further investigation is needed to examine the role of HDL-p in the link between HIV and CVD in women.
Tien
Phyllis C
PC
Department of Medicine, University of California, San Francisco, and San Francisco Veterans Affairs Medical Center, Infectious Disease Section, San Francisco, California 94121, USA. ptien@ucsf.edu
Schneider
Michael F
MF
Cox
Christopher
C
Cohen
Mardge
M
Karim
Roksana
R
Lazar
Jason
J
Young
Mary
M
Glesby
Marshall J
MJ
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control*; D008076:Cholesterol, HDL / Q000187:drug effects*; D008078:Cholesterol, LDL / Q000187:drug effects*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D010316:Particle Size; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL