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HIV, HAART, and lipoprotein particle concentrations in the Women's Interagency HIV Study

Tien, Phyllis Ca; Schneider, Michael Fb; Cox, Christopherb; Cohen, Mardgec; Karim, Roksanad; Lazar, Jasone; Young, Maryf; Glesby, Marshall Jg

doi: 10.1097/QAD.0b013e32833fcb3b
Clinical Science

Background: Changes in lipoprotein particle concentrations, especially greater small low-density lipoprotein particle (LDL-p) and lower small high-density lipoprotein particle (HDL-p) may provide information regarding cardiovascular disease (CVD) risk above and beyond that which is provided by standard lipids. We quantified the association HIV and HAART use had with LDL-p and HDL-p.

Methods: Cross-sectional study of 1077 individuals classified by HIV/HAART status (361 HIV-uninfected, 128 HIV-infected/HAART naive, 588 HIV-infected/on HAART) enrolled in the Women's Interagency HIV Study. Nuclear magnetic resonance spectroscopy estimated total and subclass lipoprotein particle concentrations. Quantile regression models were used to estimate differences in the 10th, 25th, 50th, 75th, and 90th percentiles of the distributions of lipoprotein particle concentrations between the two HIV-infected exposure groups and HIV-uninfected controls after adjustment for demographic, nonlipid metabolic factors, and standard lipids.

Results: Compared with HIV-uninfected women, those on HAART had greater 75th and 90th percentiles of small LDL-p; there was little difference between HIV-infected/HAART naive and HIV-uninfected women. After adjustment for triglycerides, the association of HAART with greater 75th and 90th percentiles of small LDL-p was attenuated and no longer significant. In contrast, after adjustment for triglycerides, HIV infection irrespective of HAART status remained associated with significantly lower 10th, 25th, 50th, 75th, and 90th percentiles of small HDL-p.

Conclusion: Our findings suggest that testing for LDL-p confers little additional information beyond triglycerides levels when assessing CVD risk. Further investigation is needed to examine the role of HDL-p in the link between HIV and CVD in women.

aDepartment of Medicine, University of California, San Francisco, and San Francisco Veterans Affairs Medical Center, San Francisco, California, USA

bDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA

cDepartments of Medicine, Stroger Hospital and Rush University, Chicago, Illinois, USA

dDepartment of Preventive Medicine, University of Southern California, Los Angeles, California, USA

eDepartment of Medicine, State University of New York-Downstate Medical Center, Brooklyn, New York, USA

fDepartment of Medicine, Georgetown University Medical Center, Washington, DC, USA

gDepartment of Medicine, Weill Cornell Medical College, New York, New York, USA.

Received 6 July, 2010

Revised 19 August, 2010

Accepted 20 August, 2010

Correspondence to Dr Phyllis Tien, University of California, San Francisco, VAMC, Infectious Disease Section, 111W, 4150 Clement Street, San Francisco, CA 94121. Tel: +1 415 221 4810 x2577; e-mail: ptien@ucsf.edu

© 2010 Lippincott Williams & Wilkins, Inc.