Abstract

This paper described dyslipidemia caused by the metabolic effects of HIV and exposure to antiretroviral therapy. The aim of this study was to appreciate the interest of the measurement of HDL sub-fractions in the monitoring of human immunodeficiency virus (HIV) infected patients on antiretroviral treatment. A case-control study was carried out on 31 HIV infected before (naive) highly active antiviral therapy (HAART naive), 33 HIV infected on HAART during one year (HAART 1 Year), 47 HIV infected on HAART between one year to five years (HAART 1 to 5 Years) and control group (43 HIV negative). Total HDL (high density lipoprotein), HDL2 and HDL3 were determined by using dextran sulfate - MgCl₂ precipitation technique in human serum. The lipid profile showed that HDL2 significantly decreased according to the rate of CD4 cells. Significant decreases of total cholesterol, HDL, HDL3 and HDL2 were observed among patients at advanced WHO CDC clinical stage. Correlation analysis showed decrease of HDL2 with age in HIV negative group (r = -0.401, p = 0.008). This correlation was not significant in HIV infected group (r = -0.134, p = 0.162). Obviously, HDL2 was inversely correlated than total HDL with BMI (r = -0.229, p = 0.001 versus r = -0.292, p = 0.001). HDL2 was positively correlated with CD4 lymphocytes (r = 0.322, p = 0.004) and duration of antiretroviral treatment (r = 0.347, p = 0.002). As a result, we have found a significant increase of HDL2 associated with a lower risk of cardiovascular diseases in patients infected with HIV-1 which were treated with a regimen including Nevirapine. If confirmed in larger studies, this finding may influence the initial choice of therapy for HIV-1 infection, and might also lead to novel approaches targeted at raising HDL2 cholesterol for cardiovascular diseases prevention.

Key words: Acquired immunodeficiency syndrome, nevirapine, dyslipidemia, cardiovascular disease.