title: Association of immune recovery with hyperlipidaemia and apolipoprotein gene polymorphisms following highly active antiretroviral therapy in a cohort of Chinese HIV patients.
abstract: OBJECTIVE
  To examine the associations between CD4 recovery, dyslipidaemia and apolipoprotein (APO) gene single nucleotide polymorphisms (SNPs) following highly active antiretroviral therapy (HAART).
  
  
  METHODS
  Retrospective observational cohort study.
  
  
  METHODS
  A major HIV care clinic in Hong Kong.
  
  
  METHODS
  197 Chinese treatment-naïve HIV patients.
  
  
  METHODS
  Maximum CD4 count and its rise 2-3 years after HAART initiation and their association with abnormal total cholesterol (TC), triglyceride (TG) and 8 selected APO SNP at multiple time points.
  
  
  RESULTS
  Before HAART, abnormal levels of TC, TG, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol were detected in 13%, 26%, 59% and 19% of the recruited patients, respectively. APOA5 -1131T>C and c.553G>T were significantly associated with high pre-HAART TG while APOE 2198C>T was correlated with high TG at baseline and/or a rise 2-3 years following HAART initiation. Poor CD4 achievement, defined as the highest CD4 count <350/μL and a net gain of <100/μL, was associated with a low CD4 count ≤200/μL at baseline and a rise of TC beyond 5.17 mmol/L following HAART with or without the use of antilipid agents. Conversely, satisfactory CD4 achievement was associated with APOC3 3238GG genotype. Applying a linear generalised estimating equation, APOA5 -1131T>C was shown to be a predictor of a weaker temporal trend for CD4 response in the presence of a low baseline CD4≤200/μL.
  
  
  CONCLUSIONS
  Dyslipidaemia plays a predictive role in impacting immunological recovery following HAART, which could be partly explained by the APO gene SNP.
authors.affiliation: Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, People's Republic of China.
authors.forename: Denise Pui-Chung
authors.initials: DP
authors.lastname: Chan
authors.affiliation: Department of Medicine, Queen Elizabeth Hospital, Kowloon, Hong Kong, People's Republic of China.
authors.forename: Man-Po
authors.initials: MP
authors.lastname: Lee
authors.affiliation: Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, People's Republic of China.
authors.forename: Ngai-Sze
authors.initials: NS
authors.lastname: Wong
authors.affiliation: Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, People's Republic of China.
authors.forename: Ross Ka-Kit
authors.initials: RK
authors.lastname: Leung
authors.affiliation: Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, People's Republic of China.
authors.forename: Claire Melinda
authors.initials: CM
authors.lastname: Naftalin
authors.affiliation: Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, People's Republic of China.
authors.forename: Shui-Shan
authors.initials: SS
authors.lastname: Lee
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D000072040:Apolipoprotein A-V / Q000097:blood / Q000235:genetics*; D044466:Asian People / Q000235:genetics; D018791:CD4 Lymphocyte Count; D002681:China; D002784:Cholesterol / Q000097:blood; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000276:immunology*; D006723:Hong Kong; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000150:complications* / Q000235:genetics / Q000276:immunology; D008055:Lipids / Q000097:blood* / Q000235:genetics; D008297:Male; D020641:Polymorphism, Single Nucleotide; D012189:Retrospective Studies; D014280:Triglycerides / Q000097:blood
chemical_list: D019380:Anti-HIV Agents; D000072040:Apolipoprotein A-V; D008055:Lipids; D014280:Triglycerides; D002784:Cholesterol
keywords: GENITOURINARY MEDICINE; IMMUNOLOGY; VIROLOGY