HIV and Hepatitis.com Coverage of the
14th Annual Conference on Retroviruses
and Opportunistic Infections (14th CROI)
February 25 - 28, 2007, Los Angeles, CA
High Dietary Fat Consumption Is Associated with Elevated Serum Lipids in HIV Positive Individuals

By Liz Highleyman

Elevated blood levels of "bad" cholesterol and triglycerides are common among people with HIV, and have been linked to use of certain antiretroviral drugs, particularly protease inhibitors (PIs).

But dietary fat consumption also appears to play a role, according to a poster presented at the 14th Conference on Retroviruses and Opportunistic Infections last month in Los Angeles.

Researchers evaluated the relationship between nutrient intake and metabolic parameters in 356 HIV positive patients without wasting (197 men and 159 women), as well as 162 HIV negative control subjects (73 men and 89 women). Participants were enrolled in metabolic studies at Massachusetts General Hospital in Boston between 1998 and 2005.

The participants' median age was 42 years, about 60% were Caucasian, and about 25% were African-American. The HIV positive patients had well-controlled HIV disease, with a mean CD4 cell count of approximately 450 cells/mm3 and a mean HIV viral load of 400 copies/mL; about 90% were receiving antiretroviral therapy, including about two-thirds taking PIs. About one-third met the criteria for metabolic syndrome, compared with about one-quarter of HIV negative control subjects. The investigators analyzed dietary intake based on 4-day food records and diet history.

Results

• HIV positive participants consumed more daily calories overall, but the difference did not reach statistical significance.

• Protein and carbohydrate consumption were similar.

• Body mass index (BMI) was also similar in the 2 groups.

• Consumption of total dietary fat, saturated fat, and cholesterol were significantly higher among HIV positive participants compared with HIV negative control subjects.

• A significantly greater proportion of HIV positive patients exceeded U.S. Recommended Dietary Allowances for saturated fat and cholesterol.

• Compared with HIV negative control subjects, HIV positive participants had:

- higher blood triglyceride levels;
- higher total cholesterol levels;
- lower high-density lipoprotein (HDL or "good") cholesterol levels;
- higher blood glucose levels;
- higher fasting insulin levels;
- more peripheral lipoatrophy (fat loss)
- higher visceral-to-subcutaneous abdominal fat ratios;
- increased waist-to-hip ratios.

• Among HIV positive participants, saturated fat consumption was significantly associated with elevated plasma triglycerides after controlling for PI use, alcohol consumption, total fat intake, and insulin level.

Conclusion

"Increased intake of saturated fat and cholesterol occurs in HIV positive patients with metabolic abnormalities in the current era of HAART," the researchers concluded. "This increase in saturated fat and cholesterol intake contributes to hypertriglyceridemia in this population and should be targeted for dietary modification."

These results suggest that patient education and diet modification are important aspects of controlling blood lipid levels, irrespective of type of antiretroviral therapy.

Massachusetts Gen Hosp, Boston, MA; NIH, Bethesda, MD.

Link to full study abstract and PDF of poster

03/16/07

Reference
H Keogh, T Joy, C Hadigan, and others. Increased Fat and Cholesterol Intake and Relationship to Serum Lipid Levels among HIV-infected Patients in the Current Era of HAART. 14th Conference on Retroviruses and Opportunistic Infections; February 25-28, 2007; Los Angeles, California. Abstract 813 (poster).













































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