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Impact of genetic factors on dyslipidemia in HIV-infected patients starting antiretroviral therapy

Egaña-Gorroño, Lander; Martínez, Esteban; Cormand, Bru; Escribà, Tuixent; Gatell, Jose; Arnedo, Mireia

doi: 10.1097/QAD.0b013e32835d0da1
Basic Science

Objective: The impact of host genetic factors on the incidence of dyslipidemia in antiretroviral-naive HIV patients starting antiretroviral therapy (ART) is not clear. We assessed the role of single nucleotide polymorphisms (SNPs) identified from previous genome-wide association studies adjusting for the contribution of nongenetic factors.

Methods: We assessed 192 SNPs in an HIV cohort who started ART (1997–2008) including a protease inhibitor or a nonnucleoside reverse transcriptase inhibitor (NNRTI). Patients had fasting plasma lipids, total cholesterol (T-Chol), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides measured prior to their ART initiation and after 1 year. A logistic regression model was constructed and multiple test was corrected using 10% false discovery rate (FDR). Haplotypes and gene interactions were analysed.

Results: A total of 727 individuals were successfully genotyped (n = 381_PI-group; n = 346_NNRTI-group). Age and hepatitis C virus (HCV) coinfection were associated with increases and decreases in T-Chol and LDL-C (P < 0.01), respectively. Protease inhibitor containing ART showed an unfavourable association with T-Chol (P < 0.01) and triglycerides (P = 7.4E−4) and NNRTI-containing ART was favourably associated with HDL-C (P < 0.01). Moreover, SNPs in apolipoprotein B (APOB) were associated with an increase of LDL-C [rs10495712 (P = 3.18E-4); rs754524 (P = 1.26E−3)]. Six SNPs in three genes showed an association with a favourable effect on HDL-C levels when ART included NNRTI: ABCA1 (rs4149313, P = 2.97E-4), LIPC (rs1800588, P = 2.13E-3; rs473224, P = 3.06E-4; rs261336, P = 2.23E−3) and CETP (rs173539, P = 2.96E−3; rs3764261, P = 1.52E-3). After 10% FDR correction for multiple testing, one and six SNPs displayed significant associations with LDL-C and HDL-C, respectively.

Conclusion: In HIV-infected patients staring ART, one SNP in APOB was associated with an increase of LDL-C. SNPs in ABCA1/LIPC/CETP were favourably associated with HDL-C when ART included NNRTI. However, an unfavourable effect on T-Chol and triglyceride levels was observed when ART included protease inhibitor. The risk of hypercholesterolaemia increased with age and decreased with HCV coinfection. These findings might help to individualize the selection of ART.

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aGenomics and Pharmacogenomics in HIV Group, Retrovirology and Viral Immunopathology Laboratory, IDIBAPS

bDepartment of Infectious Diseases, Hospital Clínic, Faculty of Medicine

cDepartment of Genetics, Faculty of Biology, University of Barcelona, Barcelona, Spain.

Correspondence to Dr Mireia Arnedo, IDIBAPS-Hospital Clínic Barcelona, Laboratori de Retrovirologia i Immunopatogenia Viral, Casanovas 143, Barcelona 08036, Spain. Tel: +34 93 2275400 x4165; fax +34 93 4037299; e-mail:

Received 21 September, 2012

Revised 22 November, 2012

Accepted 26 November, 2012

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