title: Hypertriglyceridemia in combination antiretroviral-treated HIV-positive individuals: potential impact on HIV sensory polyneuropathy.
abstract: OBJECTIVE
  in HIV populations that are aging due to improved longevity with combination antiretroviral therapy (CART), both hypertriglyceridemia (hTRG) and sensory neuropathy have become increasingly common. Sensory neuropathy is associated with substantial long-term disability and frequently requires management with analgesics. Elevated serum triglycerides (TRGs) are associated with an increased risk for sensory neuropathy in diabetes mellitus. However, the contribution of hTRG to sensory neuropathy in HIV has not been carefully evaluated.
  
  
  METHODS
  prospective, comparative, single-center, cross-sectional cohort study.
  
  
  METHODS
  clinical correlates of sensory neuropathy were assessed in HIV-positive and HIV-negative participants. HIV-sensory neuropathy was defined as one or more clinical signs of reduced distal sensation or ankle reflexes; symptoms were distal leg and foot pain, parasthesias or numbness. TRG levels were assessed along with concomitant metabolic and other risk factors including glucose, lipids, age, height, current and nadir CD4, and past or current use of protease inhibitors, dideoxynucleoside antiretrovirals (d-drugs), and statins in univariable and multivariable logistic regression.
  
  
  RESULTS
  of 436 HIV patients (median age 52 years; 75% on CART), 27% had sensory neuropathy; 48% were symptomatic. TRG levels were significantly higher in HIV-positive than HIV-negative individuals (mean ± SD, 245 ± 242 versus 160 ± 97 mg/dl; P < 0.001). Among HIV-positive patients, those with TRG levels in the highest tertile (≥ 244 mg/dl) were more likely to have sensory neuropathy than those in the lowest tertile (reference, ≤ 142 mg/dl) after adjusting for concurrent predictors (adjusted odds ratio 2.7, 95% confidence interval 1.4-5.5).
  
  
  CONCLUSIONS
  elevated triglyceride levels increased the risk for HIV-sensory neuropathy in HIV-positive individuals independently of other known risk factors.
authors.affiliation: Department of Neurosciences, USA bDepartment of Medicine, University of California, San Diego, California 92103-8231, USA.
authors.forename: Sugato
authors.initials: S
authors.lastname: Banerjee
authors.forename: J Allen
authors.initials: JA
authors.lastname: McCutchan
authors.forename: Beau M
authors.initials: BM
authors.lastname: Ances
authors.forename: Reena
authors.initials: R
authors.lastname: Deutsch
authors.forename: Patricia K
authors.initials: PK
authors.lastname: Riggs
authors.forename: Lauren
authors.initials: L
authors.lastname: Way
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Ellis
mesh_terms: D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D015228:Hypertriglyceridemia / Q000150:complications* / Q000188:drug therapy / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000150:complications* / Q000503:physiopathology / Q000821:virology; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D019562:Viral Load
chemical_list: D044966:Anti-Retroviral Agents