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Dysfunctional HDL and progression of atherosclerosis in HIV-1-infected and -uninfected adults

Theodoros Kelesidis1, Otto O Yang, Michelle A Kendall

  • 1Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.

Lipids in Health and Disease
|March 21, 2013
PubMed

Insights

In HIV-1-infected individuals, high-density lipoprotein (HDL) function changed over time and related to obesity, but did not predict atherosclerosis progression. Lower HDL levels, not function, were linked to increased carotid artery intima-media thickness (CIMT).

Area of Science:

  • Cardiovascular Health
  • Infectious Diseases
  • Lipid Metabolism

Background:

  • High-density lipoprotein (HDL) function, not just its level, may be a better atherosclerosis risk indicator.
  • Dysfunctional HDL exhibits increased redox activity and reduced antioxidant properties.
  • The association between abnormal HDL function and atherosclerosis progression in HIV-1-infected individuals remains unclear.

Purpose of the Study:

  • To investigate whether abnormal HDL function is associated with atherosclerosis progression in HIV-1-infected subjects.
  • To examine changes in HDL function over time in relation to cardiovascular risk factors and atherosclerosis progression.

Main Methods:

  • Retrospective analysis of serum HDL function in 91 subjects from a 3-year prospective study on carotid artery intima-media thickness (CIMT).
  • Participants included HIV-1-uninfected and HIV-1-positive individuals with or without protease inhibitor (PI)-based therapy.
  • HDL function was assessed via dihydrorhodamine 123 (DHR) oxidation rate (DOR), with higher DOR indicating dysfunctional HDL.

Main Results:

  • No significant association was found between DOR and HIV-1 infection status.
  • In HIV-1-infected subjects, greater waist circumference and lower serum HDL levels correlated with higher baseline DOR.
  • Over 3 years, increases in DOR were associated with white race, higher nadir CD4 count, and lower baseline CIMT.
  • Lower baseline HDL levels, but not HDL function (DOR), were significantly associated with CIMT progression.

Conclusions:

  • HDL function varied over time in HIV-1-infected individuals with low cardiovascular risk.
  • HDL function was independently linked to obesity parameters but not to CIMT progression.
  • Low baseline HDL levels, distinct from HDL function, were associated with CIMT progression.
Abstract

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