Wong Gerard, Trevillyan Janine M, Fatou Benoit, Cinel Michelle, Weir Jacquelyn M, Hoy Jennifer F, Meikle Peter J
Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia.
Infectious Diseases Unit, Alfred Hospital, Melbourne, Victoria, Australia; Department of Infectious Diseases, Faculty of Medicine, Nursing and Health Science, Monash University, Victoria, Australia.
PLoS One. 2014 Apr 14;9(4):e94810. doi: 10.1371/journal.pone.0094810. eCollection 2014.
The increased risk of coronary artery disease in human immunodeficiency virus (HIV) positive patients is collectively contributed to by the human immunodeficiency virus and antiretroviral-associated dyslipidaemia. In this study, we investigate the characterisation of the plasma lipid profiles of treated HIV patients and the relationship of 316 plasma lipid species across multiple lipid classes with the risk of future cardiovascular events in HIV-positive patients.
In a retrospective case-control study, we analysed plasma lipid profiles of 113 subjects. Cases (n = 23) were HIV-positive individuals with a stored blood sample available 12 months prior to their diagnosis of coronary artery disease (CAD). They were age and sex matched to HIV-positive individuals without a diagnosis of CAD (n = 45) and with healthy HIV-negative volunteers (n = 45).
Association of plasma lipid species and classes with HIV infection and cardiovascular risk in HIV were determined. In multiple logistic regression, we identified 83 lipids species and 7 lipid classes significantly associated with HIV infection and a further identified 74 lipid species and 8 lipid classes significantly associated with future cardiovascular events in HIV-positive subjects. Risk prediction models incorporating lipid species attained an area under the receiver operator characteristic curve (AUC) of 0.78 (0.775, 0.785)) and outperformed all other tested markers and risk scores in the identification of HIV-positive subjects with increased risk of cardiovascular events.
Our results demonstrate that HIV-positive patients have significant differences in their plasma lipid profiles compared with healthy HIV-negative controls and that numerous lipid species were significantly associated with elevated cardiovascular risk. This suggests a potential novel application for plasma lipids in cardiovascular risk screening of HIV-positive patients.
人类免疫缺陷病毒（HIV）阳性患者患冠状动脉疾病的风险增加，这是由人类免疫缺陷病毒和抗逆转录病毒相关的血脂异常共同导致的。在本研究中，我们调查了接受治疗的HIV患者的血浆脂质谱特征，以及多种脂质类别的316种血浆脂质成分与HIV阳性患者未来心血管事件风险之间的关系。
在一项回顾性病例对照研究中，我们分析了113名受试者的血浆脂质谱。病例组（n = 23）为HIV阳性个体，在诊断为冠状动脉疾病（CAD）前12个月有储存血样。他们在年龄和性别上与未诊断为CAD的HIV阳性个体（n = 45）以及健康的HIV阴性志愿者（n = 45）相匹配。
确定了血浆脂质成分和类别与HIV感染及HIV患者心血管风险的关联。在多因素逻辑回归分析中，我们确定了83种脂质成分和7种脂质类别与HIV感染显著相关，进一步确定了74种脂质成分和8种脂质类别与HIV阳性受试者未来的心血管事件显著相关。纳入脂质成分的风险预测模型在受试者工作特征曲线（AUC）下的面积为0.78（0.775, 0.785），在识别心血管事件风险增加的HIV阳性受试者方面优于所有其他测试标志物和风险评分。
我们的结果表明，与健康的HIV阴性对照相比，HIV阳性患者的血浆脂质谱存在显著差异，并且许多脂质成分与心血管风险升高显著相关。这表明血浆脂质在HIV阳性患者心血管风险筛查中具有潜在的新应用。
