Dyslipidaemia in HIV-infected women on antiretroviral therapy. Analysis of 922 patients from the Spanish VACH cohort

• Published in: BMC women's health Vol. 11; no. 1; p. 36
• Main Authors: Estrada, Vicente, Geijo, Paloma, Fuentes-Ferrer, Manuel, Alcalde, María Luisa García, Rodrigo, María, Galindo, María José, Muñoz, Agustín, Domingo, Pere, Ribera, Esteve, Cosín, Jaime, Viciana, Pompeyo, Lozano, Fernando, Terrón, Alberto, Vergara, Antonio, Teira, Ramón, Muñoz-Sánchez, Josefa, Roca, Bernardino, Sánchez, Trinitario, López-Aldeguer, José, Deig, Elisabeth, Vidal, Francisco, Pedrol, Enric, Castaño-Carracedo, Manuel, Puig, Teresa, Garrido, Myriam, Suárez-Lozano, Ignacio
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 04.08.2011; BioMed Central; BMC
• Subjects: Adult; Age Factors; Anti-Retroviral Agents - adverse effects; Anti-Retroviral Agents - therapeutic use; Antiviral agents; Body Mass Index; CD4 Lymphocyte Count; CD4-Positive T-Lymphocytes; Cholesterol - blood; Cholesterol, HDL - blood; Cohort Studies; Cross-Sectional Studies; Diagnosis; Drug therapy; Dyslipidemias; Dyslipidemias - blood; Dyslipidemias - etiology; Female; Health aspects; Hepatitis C - complications; HIV infection; HIV infection in women; HIV Infections - blood; HIV Infections - complications; HIV Infections - drug therapy; Humans; Observation; Prospective Studies; Risk factors; Spain; Triglycerides - blood; Viral Load; Women; Spain
• ISSN: 1472-6874; 1472-6874
• DOI: 10.1186/1472-6874-11-36

Information concerning lipid disturbances in HIV-infected women on antiretroviral therapy (ART) is scarce. The objective of the study is to describe the lipid profile in a large cohort of HIV-infected women on contemporary ART and analyse differences between regimes and patient's characteristics. Observational, multicentre, cross-sectional study from the Spanish VACH Cohort. 922 women on stable ART without lipid-lowering treatment were included. Median age was 42 years, median CD4 lymphocyte count was 544 cells/mm3, and 85.6% presented undetectable HIV-1 viral load. Median total cholesterol (TC) was 189 mg/dL (interquartile range, IQR, 165-221), HDL cholesterol 53 mg/dL (IQR, 44-64), LDL cholesterol 108 mg/dL (IQR, 86-134), and triglycerides 116 mg/dL (IQR, 85-163). Mean accumulated time on ART was 116 months; 47.4% were on NNRTI-based regimes, 44.7% on PI, and 6.7% on only-NRTI therapy. 43.8% were also hepatitis C (HCV) coinfected. Patients on PI treatment presented higher TC/HDL ratio than those on NNRTI (p < 0.001). Significantly higher HDL values were observed in NNRTI-treated patients. HCV-coinfected patients presented lower TC/HDL ratio than the non HCV-coinfected. In multivariate analysis, factors independently associated with TC/HDL ratio were age, triglyceride levels and HCV co-infection. PI treatment presented a non-significant association with higher TC/HDL ratio. In HIV-infected women, the NNRTI-based ART is associated with a better lipid profile than the PI-based. Factors unrelated to ART selection may also exert an independent, significant influence on lipids; in particular, age, and triglyceride levels are associated with an increased TC/HDL ratio while HCV co-infection is associated with a reduced TC/HDL ratio.