Dyslipidaemia in HIV-infected women on antiretroviral therapy. Analysis of 922 patients from the Spanish VACH cohort

Identificador:  imarina:6818082

Handle: https://hdl.handle.net/20.500.11797/imarina6818082

Autors:  Estrada, Vicente; Geijo, Paloma; Fuentes-Ferrer, Manuel; Garcia Alcalde, Maria Luisa; Rodrigo, Maria; Jose Galindo, Maria; Munoz, Agustin; Domingo, Pere; Ribera, Esteve; Cosin, Jaime; Viciana, Pompeyo; Lozano, Fernando; Terron, Alberto; Vergara, Antonio; Teira, Ramon; Munoz-Sanchez, Josefa; Roca, Bernardino; Sanchez, Trinitario; Lopez-Aldeguer, Jose; Deig, Elisabeth; Vidal, Francisco; Pedrol, Enric; Castano-Carracedo, Manuel; Puig, Teresa; Garrido, Myriam; Suarez-Lozano, Ignacio

Resum:
Background: Information concerning lipid disturbances in HIV-infected women on antiretroviral therapy (ART) is scarce. The objective of the study is to describe the lipid profile in a large cohort of HIV-infected women on contemporary ART and analyse differences between regimes and patient's characteristics. Methods: Observational, multicentre, cross-sectional study from the Spanish VACH Cohort. 922 women on stable ART without lipid-lowering treatment were included. Results: Median age was 42 years, median CD4 lymphocyte count was 544 cells/mm3, and 85.6% presented undetectable HIV-1 viral load. Median total cholesterol (TC) was 189 mg/dL (interquartile range, IQR, 165-221), HDL cholesterol 53 mg/dL (IQR, 44-64), LDL cholesterol 108 mg/dL (IQR, 86-134), and triglycerides 116 mg/dL (IQR, 85-163). Mean accumulated time on ART was 116 months; 47.4% were on NNRTI-based regimes, 44.7% on PI, and 6.7% on only-NRTI therapy. 43.8% were also hepatitis C (HCV) coinfected. Patients on PI treatment presented higher TC/HDL ratio than those on NNRTI (p < 0.001). Significantly higher HDL values were observed in NNRTI-treated patients. HCV-coinfected patients presented lower TC/HDL ratio than the non HCV-coinfected. In multivariate analysis, factors independently associated with TC/HDL ratio were age, triglyceride levels and HCV co-infection. PI treatment presented a non-significant association with higher TC/HDL ratio. Conclusions: In HIV-infected women, the NNRTI-based ART is associated with a better lipid profile than the PI-based. Factors unrelated to ART selection may also exert an independent, significant influence on lipids; in particular, age, and triglyceride levels are associated with an increased TC/HDL ratio while HCV co-infection is associated with a reduced TC/HDL ratio.