Bernal Enrique, Masiá Mar, Padilla Sergio, Gutiérrez Félix
Infectious Diseases Unit, Hospital General Universitario de Elche, Department of Clinical Medicine, Universidad Miguel Hernández, Elche, Spain.
AIDS Patient Care STDS. 2008 Jul;22(7):569-75. doi: 10.1089/apc.2007.0186.
Low high-density lipoprotein-cholesterol (HDL-C) levels have been associated with cardiovascular risk in non-HIV populations. Limited information exists on the prevalence of low HDL-C in HIV- infected patients and related factors remain largely unknown. The aims of this study were to estimate the prevalence and characteristics of low HDL-C levels in HIV-infected patients. A cross-sectional study was performed in consecutive HIV-infected patients cared for in an outpatient HIV clinic on the Mediterranean coast of Spain during a 2-month period (September 15, 2003 to November 15, 2003). HDL-C levels below 40 mg/dL were considered low. We analyzed data from 219 patients, 167 of whom were on antiretroviral therapy. The majority (45.20 %) were on non-nucleoside reverse transcriptase inhibitors (NNRTI); 22.83 % were on treatment with protease inhibitors. The prevalence of low HDL-C levels was 44.74 % (98 of 219 patients). In multivariate analysis, hypertriglyceridemia (triglycerides >150 mg/dL; odds ratio [OR], 5.65; 95% confidence interval [CI], 2.85-11.23; p = 0.0001), HIV-1 RNA viral load greater than 50 copies per milliliter (OR, 3.15; 95% CI, 1.63-6.109; p = 0.001) and antiretroviral therapy with regimens other than NNRTIs-based regimens (OR, 2.17; 95% CI, 1.12-4.16; p = 0.021) were associated with low HDL-C levels. These data indicate that prevalence of low HDL-C among HIV-infected patients from this cohort was very high. Low HDL-C was related to triglyceride levels, HIV-1 RNA viral load and antiretroviral therapy composition. Undetectable viral load and treatment with NNRTIs are protective factors, whereas hypertriglyceridemia is directly associated with low HDL-C levels.
低高密度脂蛋白胆固醇（HDL-C）水平与非HIV人群的心血管风险相关。关于HIV感染患者中低HDL-C的患病率信息有限，相关因素在很大程度上仍不清楚。本研究的目的是评估HIV感染患者中低HDL-C水平的患病率及其特征。在西班牙地中海沿岸一家门诊HIV诊所连续诊治的HIV感染患者中进行了一项为期2个月（2003年9月15日至2003年11月15日）的横断面研究。HDL-C水平低于40mg/dL被视为低水平。我们分析了219例患者的数据，其中167例正在接受抗逆转录病毒治疗。大多数患者（45.20%）使用非核苷类逆转录酶抑制剂（NNRTI）；22.83%接受蛋白酶抑制剂治疗。低HDL-C水平的患病率为44.74%（219例患者中有98例）。多变量分析显示，高甘油三酯血症（甘油三酯>150mg/dL；比值比[OR]为5.65；95%置信区间[CI]为2.85-11.23；p=0.0001）、HIV-1 RNA病毒载量大于每毫升50拷贝（OR为3.15；95%CI为1.63-6.109；p=0.001）以及使用非基于NNRTI方案的抗逆转录病毒治疗（OR为2.17；95%CI为1.12-4.16；p=0.021）与低HDL-C水平相关。这些数据表明，该队列中HIV感染患者低HDL-C的患病率非常高。低HDL-C与甘油三酯水平、HIV-1 RNA病毒载量和抗逆转录病毒治疗组成有关。病毒载量检测不到和使用NNRTI治疗是保护因素，而高甘油三酯血症与低HDL-C水平直接相关。
