The aims of the current study, conducted at the Hospital General Universitario de Elche, Universidad Miguel Hernández in Elche, Spain, were to assess the prevalence and characteristics of low HDL levels in HIV patients. Results were published in the May 15, 2008, advance online edition of AIDS Patient Care and STDs.

Specifically, the researchers conducted a cross-sectional study of consecutive HIV positive patients at an outpatient HIV clinic on the Mediterranean coast of Spain during a 2-month period (September 15 to November 15, 2003).

The investigators analyzed data from 219 individuals, 167 of whom were on antiretroviral therapy. The largest proportion (45.20%) was taking regimens containing non-nucleoside reverse transcriptase inhibitors (NNRTIs), while 22.83% were treated with protease inhibitor-based regimens.

HDL levels below 40 mg/dL were considered to be low.

Results

• 98 of 219 patients (44.74%) had low HDL levels.

• In a multivariate analysis, the following factors were associated with low HDL:

• Hypertriglyceridemia (triglycerides >150 mg/dL) (P = 0.0001);

• Detectable HIV RNA viral load greater than 50 copies/mL (P = 0.001);

• Antiretroviral therapy other than NNRTI-based regimens (P = 0.021),

Conclusion

"These data indicate that prevalence of low HDL among HIV-infected patients from this cohort was very high," wrote the study authors. "Low HDL was related to triglyceride levels, HIV-1 RNA viral load and antiretroviral therapy composition," the added. "[U]ndetectable viral load and treatment with NNRTIs are protective factors, whereas hypertriglyceridemia is directly associated with low HDL levels."

In summary, they concluded, "our results indicate that a high proportion of HIV-infected patients have low HDL cholesterol concentrations, and support an association of HDL cholesterol levels with HIV-1 viral load, and antiretroviral status and composition."

Finally, they recommended, "Attention should be paid to patients discontinuing antiretroviral therapy, since a higher frequency of low HDL cholesterol levels might be encountered, that could implicate a higher risk of future cardiovascular events."

Cholesterol is transported to the artery wall by LDL and
transported from the artery wall back to the liver by HDL.

Hospital General Universitario de Elche, Universidad Miguel Hernández, Elche, Spain.

6/03/08

Reference
E Bernal, M Masia, S Padilla, and others. High-Density Lipoprotein Cholesterol in HIV-infected Patients: Evidence for an Association with HIV-1 Viral Load, Antiretroviral Therapy Status, and Regimen Composition. AIDS Patient Care and STDs. May 15, 2008 [Epub ahead of print].