School of Public Health, Bengbu Medical College, Bengbu, 233000, Anhui, China.
Senior Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China.
Lipids Health Dis. 2023 Feb 23;22(1):27. doi: 10.1186/s12944-023-01786-3.
Hypertriglyceridemia is associated with subclinical atherosclerosis and vascular inflammation even when low-density lipoprotein cholesterol levels are normal. However, few cohort studies on hypertriglyceridemia have been conducted in males with higher susceptibility to human immunodeficiency virus (HIV)-related deterioration of arterial structure and function. Our objective was to investigate the incidence of hypertriglyceridemia during treatment with combination antiretroviral therapy (cART) in males with HIV and explore its related risk factors.
In this retrospective study, we included 309 males living with HIV (median age 31 years [interquartile range 26-42.5]) who initiated cART treatment in our hospital from January 2013 to December 2018. We collected follow-up data on serum triglycerides and other related information as of June 31, 2021. A Cox proportional hazards regression model was used to analyze the related risk factors.
In 666.7 person-years, hypertriglyceridemia occurred in 140 patients (triglyceride ≥2.3 mmol/L [200 mg/dL]), and the incidence rate was 21.0 per 100 person-years (Patients who took the lamivudine [3TC] + tenofovir disoproxil fumarate [TDF] + efavirenz [EFV] regimen accounted for 77.0% of the total patients.). Multiple Cox regression analysis showed that baseline CD4/CD8 ratio < 0.20 (hazard ratio [HR], 2.705 [95% confidence interval (CI): 1.381-5.296]; P = 0.004}, body mass index (BMI) ≥ 24.0 kg/m (HR, 1.768 [95% CI: 1.225-2.552]; P = 0.002), borderline high triglyceride at baseline (HR, 3.457 [95% CI: 2.162-5.527]; P < 0.001), and 3TC + zidovudine (AZT) + EFV regimen (HR, 2.702 [95% CI: 1.593-4.581]; P < 0.001), or 3TC + TDF + lopinavir/ritonavir (LPV/r) regimen (HR, 4.349 [95% CI: 2.664-7.102]; P < 0.001) were independent risk factors for hypertriglyceridemia.
During the course of cART treatment, the incidence of hypertriglyceridemia in males with HIV was high. The main risk factors influencing its occurrence are a low baseline CD4/CD8 ratio, overweight and obesity, and the use of AZT or LPV/r in the cART regimen.
即使低密度脂蛋白胆固醇水平正常，高甘油三酯血症也与亚临床动脉粥样硬化和血管炎症有关。然而，在易受人类免疫缺陷病毒（HIV）相关动脉结构和功能恶化影响的男性中，针对高甘油三酯血症的队列研究较少。我们的目的是研究男性 HIV 感染者在接受联合抗逆转录病毒治疗（cART）期间高甘油三酯血症的发生率，并探讨其相关危险因素。
在这项回顾性研究中，我们纳入了 2013 年 1 月至 2018 年 12 月在我院接受 cART 治疗的 309 名男性 HIV 感染者（中位年龄 31 岁[四分位间距 26-42.5]）。我们收集了截至 2021 年 6 月 31 日的随访血清甘油三酯和其他相关信息。使用 Cox 比例风险回归模型分析相关危险因素。
在 666.7 人年中，140 名患者（甘油三酯≥2.3mmol/L[200mg/dL]）发生高甘油三酯血症，发生率为 21.0/100 人年（接受拉米夫定[3TC]+替诺福韦二吡呋酯[TDF]+依非韦伦[EFV]方案治疗的患者占总患者的 77.0%）。多因素 Cox 回归分析显示，基线 CD4/CD8 比值<0.20（风险比[HR]，2.705[95%置信区间（CI）：1.381-5.296]；P=0.004）、体重指数（BMI）≥24.0kg/m（HR，1.768[95%CI：1.225-2.552]；P=0.002）、基线时边缘性高甘油三酯（HR，3.457[95%CI：2.162-5.527]；P<0.001）、3TC+齐多夫定（AZT）+EFV 方案（HR，2.702[95%CI：1.593-4.581]；P<0.001）或 3TC+TDF+洛匹那韦/利托那韦（LPV/r）方案（HR，4.349[95%CI：2.664-7.102]；P<0.001）是高甘油三酯血症的独立危险因素。
在 cART 治疗过程中，男性 HIV 感染者高甘油三酯血症的发生率较高。影响其发生的主要危险因素是基线 CD4/CD8 比值低、超重和肥胖以及 cART 方案中使用 AZT 或 LPV/r。
