State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou 310003, China.
Biomed Res Int. 2019 Feb 5;2019:2870647. doi: 10.1155/2019/2870647. eCollection 2019.
We assess long-term changes in lipid levels in human immunodeficiency disease- (HIV-) infected patients undergoing highly active antiretroviral treatment (HAART) and their association with diabetes mellitus (DM) and thyroid dysfunction. We observed changes in the levels of total cholesterol (TC) and total triglyceride (TG) of 63 HIV-infected patients in the 6 years from starting HAART and analyzed correlations between relevant parameters. TC levels of patients with normal baseline TC levels as well as those diagnosed with DM or impaired fasting glucose (IFG) increased significantly ( < 0.05) as did the TG levels of patients with normal baseline TG levels ( < 0.05). TC levels of patients with hypercholesterolemia in the year HAART was initiated were significantly higher than those of patients with normal baseline TC levels ( < 0.05) for all 6 years. TC levels of patients diagnosed with DM were significantly higher than those with euglycemia ( < 0.05) 2 and 4 years after HAART commencement. Levels of TC, high-density lipoprotein-cholesterol (HDL-C), and low-density lipoprotein-cholesterol (LDL-C) were correlated negatively with viral load, whereas levels of TC and very-low-density lipoprotein-cholesterol (VLDL-C) were correlated positively with CD4+ cell counts before HAART commencement. Linear mixed-effect model demonstrated disturbance of glucose metabolism and HAART containing nevirapine and CD4+ cell count were positively correlated with TC levels after HAART commencement. These findings suggest that there are changes in the lipid levels of patients undergoing HAART, with the potential risk of dyslipidemia.
我们评估了接受高效抗逆转录病毒治疗（HAART）的人类免疫缺陷病毒（HIV）感染患者的血脂水平的长期变化及其与糖尿病（DM）和甲状腺功能障碍的关系。我们观察了 63 名 HIV 感染患者在开始 HAART 的 6 年内总胆固醇（TC）和总甘油三酯（TG）水平的变化，并分析了相关参数之间的相关性。基线 TC 水平正常以及患有 DM 或空腹血糖受损（IFG）的患者的 TC 水平显著升高（ < 0.05），基线 TG 水平正常的患者的 TG 水平也显著升高（ < 0.05）。起始 HAART 年度高胆固醇血症患者的 TC 水平显著高于基线 TC 水平正常的患者（ < 0.05），所有 6 年均如此。起始 HAART 后 2 年和 4 年，DM 患者的 TC 水平明显高于血糖正常的患者（ < 0.05）。TC、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）水平与病毒载量呈负相关，而 TC 和极低密度脂蛋白胆固醇（VLDL-C）水平与 HAART 前的 CD4+细胞计数呈正相关。线性混合效应模型表明，葡萄糖代谢紊乱和包含奈韦拉平的 HAART 与 CD4+细胞计数与 HAART 后 TC 水平呈正相关。这些发现表明，接受 HAART 的患者的血脂水平发生了变化，存在血脂异常的潜在风险。
