Asztalos Bela F, Schaefer Ernst J, Horvath Katalin V, Cox Caitlin E, Skinner Sally, Gerrior Jul, Gorbach Sherwood L, Wanke Christine
Lipid Metabolism Laboratory, Jean Mayer USDA Human Nutrition Center on Aging, Tufts University, Boston, MA 02111, USA.
Atherosclerosis. 2006 Jan;184(1):72-7. doi: 10.1016/j.atherosclerosis.2005.04.013. Epub 2005 Jun 1.
To study the effects of HIV-infection and protease inhibitor (PI)-based highly active anti-retroviral therapy (HAART) on the lipid and high-density lipoprotein (HDL) subpopulation profile and to relate the changes to coronary heart disease (CHD)-risk.
The lipid and HDL subpopulation profiles of HIV-positive subjects (n = 48) were studied prospectively by comparing pre- and post-PI-HAART data as well as cross-section by comparing the profiles to HIV-negative subjects with (n = 96) and without CHD (n = 96).
HIV-infected HAART-naïve subjects had lower concentrations of low-density lipoprotein cholesterol (LDL-C) and HDL-C and higher concentration of triglycerides (TG) than healthy controls. After receiving PI-based HAART, LDL-C and TG concentrations increased, while HDL-C concentrations remained unchanged. The HDL subpopulation profiles of HAART-naïve HIV-positive patients were significantly different from those of healthy controls and were similar to those with CHD. Moreover, the HDL subpopulation profile changed unfavorably after PI-based HAART, marked with increased concentrations of the small, lipid-poor pre-beta-1 HDL (32% or 3.9 mg/dl; p < 0.001), and decreased concentration of the large, cholesterol-rich alpha-1 HDL (9% or 1 mg/dl ns).
An already unfavorable lipid and HDL subpopulation profile of HIV-positive HAART-naïve subjects further deteriorated after receiving PI-based treatment, which may cause increased CHD-risk in these subjects.
研究人类免疫缺陷病毒（HIV）感染及基于蛋白酶抑制剂（PI）的高效抗逆转录病毒疗法（HAART）对脂质及高密度脂蛋白（HDL）亚群分布的影响，并将这些变化与冠心病（CHD）风险相关联。
通过比较PI-HAART治疗前后的数据，对48例HIV阳性受试者的脂质及HDL亚群分布进行前瞻性研究，并通过将这些分布与96例有CHD和96例无CHD的HIV阴性受试者进行横断面比较。
未接受HAART治疗的HIV感染受试者的低密度脂蛋白胆固醇（LDL-C）和HDL-C浓度低于健康对照组，甘油三酯（TG）浓度高于健康对照组。接受基于PI的HAART治疗后，LDL-C和TG浓度升高，而HDL-C浓度保持不变。未接受HAART治疗的HIV阳性患者的HDL亚群分布与健康对照组有显著差异，与CHD患者相似。此外，基于PI的HAART治疗后HDL亚群分布发生不利变化，表现为小的、脂质含量低的前β-1 HDL浓度增加（32%或3.9mg/dl；p<0.001），大的、富含胆固醇的α-1 HDL浓度降低（9%或1mg/dl，无统计学意义）。
未接受HAART治疗的HIV阳性受试者本已不利的脂质及HDL亚群分布在接受基于PI的治疗后进一步恶化，这可能导致这些受试者的CHD风险增加。
