Vnitr Lek 2008, 54(2):169-177

Dyslipidaemia inducted by antiretroviral agents

S. Snopková^1,*, K. Povolná¹, P. Husa¹, J. Jarkovský², T. Pavlík²

¹ Klinika infekčních chorob Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Petr Husa, CSc.

² Institut biostatistiky a analýz Masarykovy univerzity Brno, ředitel doc. RNDr. Ladislav Dušek, Dr.

The clinical course of HIV/AIDS has been substantially modified by up-to date therapy in the recent years. The progress of the disorder has changed - today it is a chronic disease of many years course. Already in 1997 and 1998 it turned out that adverse metabolic changes which significantly affect the subsequent progress of the disease were produced by long-term HAART (highly active antiretroviral therapy). Gradually, more and more anthropometric, metabolic and coagulation changes are detected, closely resembling the changes seen in the metabolic syndrome, well known from cardiology and internal medicine - dyslipoproteinaemia, insulin resistance, abdominal obesity and so on. A combination of these disorders is clinically significant due to their role in the development of atherosclerosis and their, by no means negligible, involvement in the onset of ischaemic heart disease. In view of the much lower average age of HIV-positive individuals the earlier mentioned complications should be expected in much lower age categories than with HIV-negative individuals. Plasma lipid fractions (total cholesterol, triglycerides, LDL-cholesterol, HDL-cholesterol, apoA-I, apoB, LDL/HDL, apoA-I/apoB) have been investigated in 69 HIV infected subjects and the changes of these parameteres in the course of progression of HIV/AIDS due to cumulative time of exposure to HAART were explored. Significant increase of the level of proatherogenic plasma lipid fractions with tendency to develop at time course was found. These disturbances are observed in the course of very good immunological stabilization and viral suppression. No unambiguous data and results of long term studies are available, that would confirm the increase of cardiovascular risk in HIV infected subjects. Nevertheless, this increase is required and anticipated.

Keywords: HIV; HAART; dyslipidaemia; cardiovascular risk

Received: August 13, 2007; Accepted: November 16, 2007; Published: February 1, 2008  Show citation