Association of non-HDL cholesterol with subclinical atherosclerosis in HIV-positive patients

Area of Science:

• Cardiology
• HIV Medicine
• Metabolic Disorders

Background:

• Cardiovascular disease is a major concern in HIV-positive (HIV+) populations.
• Non-classical cardiovascular risk factors may contribute to accelerated atherosclerosis in HIV+ individuals.
• Metabolic syndrome (MS) is prevalent and associated with increased cardiovascular risk.

Purpose of the Study:

• To evaluate the association between non-classical cardiovascular risk factors (non-HDL-C, apolipoprotein B, TG/HDL ratio, LDL size, inflammation, oxidative stress) and carotid intima-media thickness (CIMT).
• To investigate the relationship between metabolic syndrome (MS) and CIMT in HIV+ adults.
• To identify improved targets for prevention and therapy in HIV+ patients.

Main Methods:

• Cross-sectional study of 232 HIV+ adults from the ANRS CO3 Aquitaine Cohort.
• Analysis of non-classical cardiovascular risk factors including lipid parameters, inflammation, and oxidative stress markers.
• Assessment of carotid intima-media thickness (CIMT) as a marker of subclinical atherosclerosis.

Main Results:

• Higher non-HDL-C, apolipoprotein B, and TG/HDL ratio were significantly associated with increased CIMT.
• No significant association was found between CIMT and LDL-C or LDL size.
• Metabolic syndrome, by either NCEP-ATP III or IDF criteria, was significantly associated with increased CIMT in both univariate and multivariate analyses.

Conclusions:

• Non-HDL-C, TG/HDL ratio, and apolipoprotein B are stronger predictors of subclinical atherosclerosis in HIV+ populations than LDL-C.
• Lipid disorders associated with MS are key factors in identifying atherosclerosis risk.
• Achieving non-HDL-C targets is important for reducing cardiovascular complications in HIV+ patients.