title: Dyslipidemias and Elevated Cardiovascular Risk on Lopinavir-Based Antiretroviral Therapy in Cambodia.
abstract: BACKGROUND
  Lopinavir/ritonavir (LPV/r) is widely used in Cambodia with high efficacy but scarce data exist on long-term metabolic toxicity.
  
  
  METHODS
  We carried out a cross-sectional and retrospective study evaluating metabolic disorders and cardiovascular risk in Cambodian patients on LPV/r-based antiretroviral therapy (ART) for > 1 year followed in Calmette Hospital, Phnom Penh. Data collected included cardiovascular risk factors, fasting blood lipids and glucose, and retrospective collection of bioclinical data. We estimated the 10-year risks of coronary heart disease with the Framingham, Ramathibodi-Electricity Generating Authority of Thailand (Rama-EGAT), and the Data Collection on Adverse Effects of Anti-HIV Drugs (D:A:D) risk equations. We identified patients with LDL above targets defined by the French expert group on HIV and by the HIV Medicine Association of the Infectious Disease Society of America and the Adult AIDS Clinical Trials Group (IDSA-AACTG).
  
  
  RESULTS
  Of 115 patients enrolled-mean age 40.9 years, 69.2% male, mean time on LPV/r 3.8 years-40 (34.8%) had hypercholesterolemia (> 2.40 g/L), and 69 (60.0%) had low HDL cholesterol (< 0.40 g/L). Twelve (10.5%), 28 (24%) and 9 (7.7%) patients had a 10-year risk of coronary heart disease ≥ 10% according to the Framingham, D:A:D, and Rama-EGAT score, respectively. Fifty one (44.4%) and 36 (31.3%) patients had not reached their LDL target according to IDSA-AACTG and French recommendations, respectively.
  
  
  CONCLUSIONS
  Prevalence of dyslipidemia was high in this cohort of HIV-infected Cambodian patients on LPV/r. Roughly one third had high LDL levels requiring specific intervention.
authors: Hôpital Calmette, Phnom Penh, Cambodia.
authors: Setha
authors: S
authors: Limsreng
authors: ESTHER Cambodia, Phnom Penh, Cambodia.|Epidemiology and Public Health Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia.
authors: Olivier
authors: O
authors: Marcy
authors: Epidemiology and Public Health Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia.
authors: Sowath
authors: S
authors: Ly
authors: Hôpital Calmette, Phnom Penh, Cambodia.
authors: Vara
authors: V
authors: Ouk
authors: Hôpital Calmette, Phnom Penh, Cambodia.
authors: Hak
authors: H
authors: Chanroeurn
authors: Hôpital Calmette, Phnom Penh, Cambodia.
authors: Saem
authors: S
authors: Thavary
authors: Hôpital Calmette, Phnom Penh, Cambodia.
authors: Ban
authors: B
authors: Boroath
authors: Internal Medecine Department, Bicêtre Hospital, le Kremlin Bicêtre, France.
authors: Ana
authors: A
authors: Canestri
authors: ESTHER, Paris, France.
authors: Gérald
authors: G
authors: Viretto
authors: Internal Medecine Department, Bicêtre Hospital, le Kremlin Bicêtre, France.
authors: Jean-François
authors: JF
authors: Delfraissy
authors: Internal Medecine Department, Bicêtre Hospital, le Kremlin Bicêtre, France.
authors: Olivier
authors: O
authors: Ségéral
mesh_terms: D000328:Adult; D002160:Cambodia / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000097:blood / Q000139:chemically induced / Q000453:epidemiology; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000097:blood / Q000139:chemically induced / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology; D017320:HIV Protease Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D015497:HIV-1; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood; D061466:Lopinavir / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged
chemical_list: D017320:HIV Protease Inhibitors; D008077:Lipoproteins, LDL; D061466:Lopinavir