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Characterization of lipid composition and high-density lipoprotein function in HIV-infected individuals on stable

Alana M Munger1, Dominic C Chow, Martin P Playford

  • 11 Hawaii Center for AIDS, University of Hawaii , Honolulu, Hawaii.

AIDS Research and Human Retroviruses
|November 23, 2014
PubMed

Insights

Individuals with HIV on stable antiretroviral therapy show an atherogenic lipoprotein profile, with increased LDL particle number and reduced HDL function, despite normal traditional lipid panels. This highlights the need for advanced lipid testing in HIV patients to assess cardiovascular disease risk.

Area of Science:

  • Cardiovascular Disease Research
  • Lipid Metabolism and Atherosclerosis
  • HIV/AIDS Pathophysiology

Background:

  • Increased cardiovascular disease (CVD) morbidity is observed in individuals with HIV.
  • Traditional lipid measures may not fully capture the inflammatory lipid modulation contributing to CVD risk in HIV.
  • Advanced lipoprotein phenotyping is crucial for a comprehensive risk assessment.

Purpose of the Study:

  • To conduct advanced lipoprotein phenotyping in HIV-infected patients on stable antiretroviral therapy (ART).
  • To assess high-density lipoprotein (HDL) cholesterol efflux capacity, and lipoprotein particle concentration and size.
  • To determine associations between advanced lipoprotein parameters and cardiometabolic risk factors.

Main Methods:

  • Study included 118 well-phenotyped patients infected with HIV on stable ART.
  • Advanced lipoprotein phenotyping using NMR spectroscopy.
  • Analysis of HDL cholesterol efflux capacity, lipoprotein particle number, and size.
  • Simple and multivariable regression analyses were performed.

Main Results:

  • Participants had normal traditional lipid panels but demonstrated an atherogenic profile via advanced testing.
  • Elevated LDL particle number (median 1,233 nmol/L) and decreased LDL size (median 20.4 nm) were observed.
  • Reduced large HDL particles (median 3.15 μmol/L) and diminished HDL cholesterol efflux capacity were noted.
  • HDL efflux capacity correlated with HDL levels, small LDL particle concentration, insulin sensitivity (Matsuda index), and Framingham Risk Score.

Conclusions:

  • HIV-infected patients on stable ART exhibit an atherogenic lipoprotein profile, characterized by altered LDL and HDL parameters, despite normal conventional lipid levels.
  • Advanced lipoprotein phenotyping and HDL efflux capacity assessment are vital for accurate CVD risk stratification in this population.
  • These findings underscore the complex interplay between HIV, ART, lipid metabolism, and cardiovascular risk.

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