Dyslipidemia and cardiovascular risk assessment in HIV-positive patients

OBJECTIVE
Dyslipidemia is a major complication of antiretroviral treatment. Aim of the present study was to screen baseline lipid levels and cardiovascular disease risk in HIV-positive patients and analyze change in those parameters after initiation of antiretroviral treatment (ART).

METHODS
HIV-positive patients who presented at our clinic between April 2011 and August 2012 were included. Study included 19 female (22.1%) and 67 male (77.9%) patients (mean age 39.5±10.3 years). Blood pressure, smoking habit, alcohol consumption, serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), glucose level, and antiretroviral treatment status data were reviewed retrospectively. Changes in lipid profile and lifetime risk for atherosclerotic cardiovascular disease (ASCVD) according to the American College of Cardiology guidelines were compared with baseline data and analyzed.

RESULTS
At baseline, 13 (15.1%) patients were already receiving ART and 73 (84.9%) patients were treatment-naive or had stopped therapy ≥3 months prior to enrollment. At last visit, 73 (84.9%) patients were taking ART. Results of baseline and final visit TC levels were 175.5 mg/dL (range: 90–346 mg/dL) and 196.5 mg/dL (range: 104–317 mg/dL), respectively (p=0.001). HDL levels were 40 mg/dL (range: 21–81 mg/dL) and 35 mg/dL (range: 10–75 mg/dL; p=0.001), and LDL levels were 101.5 mg/dL (range: 32–191 mg/dL) and 120.5 mg/dL (range: 32–250 mg/dL; p<0.001). TG levels were 145.5 mg/dL (range: 43–2580 mg/dL and 152.5 mg/dL (range: 67–884 mg/dL; p=0.102). Baseline ASCVD risk score was 46% (range: 5–69%) while last visit ASCVD risk score was 50% (range: 5-69%; p<0.001).

CONCLUSION
HIV infection has adverse effects on lipid profiles and cardiovascular risk of HIV-positive patients. Therefore, patients should be closely monitored for lifestyle interventions and lipid-lowering agents.