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Atherogen lipid profile in HIV-1-infected patients with lipodystrophy syndrome

2000; Elsevier BV; Volume: 11; Issue: 5 Linguagem: Inglês

10.1016/s0953-6205(00)00103-5

1879-0828

P. Mercié, S. Tchamgoué, Rodolphe Thiébaut, Jean‐François Viallard, I. Faure, Valentin Dancourt, Catherine Marimoutou, François Dabis, P Rispal, Yves-Michel Darmon, B Leng, Jean‐Luc Pellegrin,

HIV/AIDS drug development and treatment

Background: Cases of lipodystrophy syndrome and metabolic disorders have been described since the onset of highly active antiretroviral therapy in HIV-infected patients. The aim of our study was to estimate the prevalence of lipodystrophy (LD) and to define the associated lipid profile of these patients. Methods: The following were determined for each patient: lipid profile (cholesterol and its subfractions, atherogenicity ratios, and triglycerides), blood glucose, and immunovirological markers (CD4+ cell count and plasma viral load). Patients were classified into two groups on the basis of whether or not they presented with clinical signs of LD. Results: Among 233 HIV-infected patients included in the study, 61 cases (26.1%) of lipodystrophy (LD) were noted. Compared with non-LD patients (NLD), LD patients were older men (P<10−4) with a lower CD4+ lymphocyte cell count (P<0.007) and more often at the AIDS stage (P<10−3) (OR=3.2 (95% CI: 1.47–6.2)). Multivariate analysis showed a correlation between LD cases and age (10 years older) (OR=1.78 (95% CI: 1.23–2.57), P<0.002) and the decrease in CD4+ cell count (100 CD4+/mm3 lower) (OR=1.31 (95% CI: 1.09–1.58), P<0.004). An analysis of lipid subfractions and atherogenicity ratios clearly indicated a proatherogenic lipid profile for the LD patients. Conclusions: The underlying physiopathological mechanism of LD is still unknown. However, the lipid profile of HIV-1-infected patients with a LD syndrome appears to place these patients at an increased risk of progression of atherosclerosis.