Sex differences in HAART-associated dyslipidaemia

Area of Science:

• Cardiovascular Health
• Infectious Diseases
• Metabolic Disorders

Background:

• Female sex typically confers protection against dyslipidemia and atherosclerosis.
• Highly active antiretroviral therapy (HAART) is a critical treatment for HIV/AIDS.
• Understanding sex-specific metabolic effects of HAART is crucial for patient management.

Purpose of the Study:

• To investigate potential sex differences in metabolic side effects of HAART.
• To correlate metabolic changes with endothelial cell activation (measured by cE-selectin).
• To assess if HAART alters the protective cardiovascular profile observed in women.

Main Methods:

• Prospective longitudinal cohort study at a tertiary care center.
• Enrolled HIV-seropositive men (n=27) and women (n=13) with high viral load, and 35 healthy controls.
• Measured serum lipids, insulin, leptin, and circulating E-selectin (cE-selectin) at baseline, 3, and 6 months post-HAART initiation.

Main Results:

• HAART increased triglycerides, leptin, and LDL cholesterol, with more pronounced effects in women.
• Fasting insulin and LDL:HDL ratio increased only in female HIV patients.
• Endothelial activation (cE-selectin) decreased more in men; women showed higher triglycerides and leptin post-therapy.

Conclusions:

• Metabolic adverse effects of HAART are more pronounced in women than in men.
• Female HIV-infected patients may lose some of their natural protection against atherosclerosis during HAART.
• Sex-specific monitoring and management strategies for HAART-related metabolic complications are warranted.