title: Cardiovascular Disease-Risk Markers in HIV Patients.
abstract: OBJECTIVE
  HIV-positive patients have an increased risk for CVD; however, the underlying mechanisms are not well understood. Our goal was to assess traditional and emerging CVD-risk factors in the CARE Study, a well-described cohort of HIV-infected adults.
  
  
  METHODS
  We analyzed demographic and clinical (viral load, CD4 count, ART regimen, cIMT) data including markers of lipid and glucose homeostasis in 176 HIV-positive subjects receiving regular care for HIV infection.
  
  
  RESULTS
  No significant association between cIMT and LDL-C level was observed. HIV patients had significantly lower level of the large α-1 HDL particles and about 3-fold higher level of the small pre β-1 HDL particles than the normal population, but these parameters were not significantly associated with cIMT. Components of the metabolic syndrome, high TG/low HDL-C, insulin resistance and high BMI, as well as viral load were significant but moderate contributors to increased cIMT.
  
  
  CONCLUSIONS
  The major lipid disorder was low HDL-C and high TG level in this HIV-positive cohort. LDL-C was not elevated. These and previously published data indicate that HIV infection and HIV medications influence CVD risk by impairing cholesterol removal (efflux) via ABCA1 from macrophages. Decreasing CVD risk in HIV patients, with impaired cholesterol efflux from macrophages, may require a lower LDL-C goal than recommended for HIV-negative patients and also a better control of TG level.
authors.affiliation: Lipid Metabolism Laboratory, Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA, USA ; Division of Nutrition and Infection, Department of Public Health and Community Medicine, Tufts University School of Medicine, 150 Harrison Avenue, Boston, MA, USA.
authors.forename: Bela F
authors.initials: BF
authors.lastname: Asztalos
authors.affiliation: Lipid Metabolism Laboratory, Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Matera
authors.affiliation: Lipid Metabolism Laboratory, Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA, USA.
authors.forename: Katalin V
authors.initials: KV
authors.lastname: Horvath
authors.affiliation: Lipid Metabolism Laboratory, Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Horan
authors.affiliation: Lipid Metabolism Laboratory, Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA, USA.
authors.forename: Mariko
authors.initials: M
authors.lastname: Tani
authors.affiliation: Department of Radiology, Tufts University School of Medicine, 145 Harrison Avenue, Boston, MA, USA.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Polak
authors.affiliation: Division of Nutrition and Infection, Department of Public Health and Community Medicine, Tufts University School of Medicine, 150 Harrison Avenue, Boston, MA, USA.
authors.forename: Sally
authors.initials: S
authors.lastname: Skinner
authors.affiliation: Division of Nutrition and Infection, Department of Public Health and Community Medicine, Tufts University School of Medicine, 150 Harrison Avenue, Boston, MA, USA.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Wanke
keywords: ART; CVD risk; HIV