Changes In Blood Lipids And Risk Factors Of HIV-1 Infected People Receiving Antiretroviral Therapy

ObjectiveHIV(Human immunodeficiency virus)infection is a severe global challenge.Despite an apparent decline in mortality of HIV-1 infected individuals due to the broad utilization of antiretroviral therapy,life-long treatment is required,accompanying with various metabolic abnormalities like dyslipidemia.Data about the epidemiology and the dynamic change of dyslipidemia in HIV-1 infected patients receiving antiretroviral therapy were mostly from European countries.The purpose was to explore the specific situation of dyslipidemia in adult Chinese HIV-1infected patients upon large multicenter clnical trials.MethodsWe conducted a retrospective cross-sectional analysis on patients enrolled in two large multicenter clinical trials across China and patients followed the clinic of Peking Union Medical Hospital.Demographic data and clinical parameters were collected,and the prevalence,risk factors,and longitudinal changes of lipid profiles under different clinical settings associated with HIV-1 infection were analyzed.ResultsA total of 1942 patients were enrolled.The longest follow up time was 10 years.In total,36 patients developed atherosclerotic disease and only 1 patient was diagnosed with acute pancreatitis.At baseline,the levels of TC,TG,HDL-C and LDL-C were 4.1±0.96 mmol/L,1.24(0.87-1.8)mmol/L,1.11±0.33 and 2.38±0.78 mmol/L,respectively.The prevalence of hypercholesterolemia,hyperglyceridemia,low HDL-C and high LDL-C were 11.38%,28.16%,45.66%and 9.29%,respectively.The overall prevalence of dyslipidemia is 69.3%,which raised significantly higher after antiretroviral therapy.Univariate analysis showed that CD4/CD8 ratio less than 0.3 and viral load over 105 copies/ml were risk factors for all subtypes of dyslipidemia.Regimens including EFV and TDF performed better lipid profiles when compared to people receiving AZTConclusionsThe prevalence of dyslipidemia was high in HIV-1 patients and elevated after antiretroviral therapy,mainly represented as high TG and low HDL-C,associating with high viral load and low CD4/CD8 ratio.EFV has less impact on lipid metabolism than AZT.Few events of cardiovascular disease or pancreatitis was found in clinical practice despite the high prevalence of dyslipidemia.