Dyslipidaemia in HIV-infected women on antiretroviral therapy. Analysis of 922 patients from the Spanish VACH cohort
1 Hospital Clínico San Carlos, Madrid, Spain
2 Hospital Virgen de la Luz, Cuenca, Spain
3 Hospital Clínico San Carlos, Madrid, Spain
4 Hospital de Cabueñes, Asturias, Spain
5 Hospital Clínico San Carlos, Madrid, Spain
6 Hospital Clínico, Valencia, Spain
7 Hospital Infanta Cristina, Badajoz, Spain
8 Hospital Santa Creu i S. Pau, Barcelona, Spain
9 Hospital Vall d'Hebron, Barcelona, Spain
10 Hospital Gregorio Marañón, Madrid, Spain
11 Hospital Virgen del Rocío, Sevilla, Spain
12 Hospital de Valme, Sevilla, Spain
13 Hospital SAS, Jerez, Spain
14 Hospital Clínico Puerto Real, Spain
15 Hospital Sierrallana, Torrelavega, Spain
16 Hospital Basurto, Bilbao, Spain
17 Hospital General, Castellón, Spain
18 Hospital Virgen del Rosell, Cartagena, Spain
19 Hospital La Fe, Valencia, Spain
20 Hospital General, Granollers, Spain
21 Hospital Joan XXIII, Tarragona, Spain
22 Xarxa Social i Sanitaria Santa Tecla, Tarragona, Spain
23 Hospital Carlos Haya, Málaga, Spain
24 Hospital Arnau Vilanova, Lleida, Spain
25 AM-VACH, Huelva, Spain
26 Hospital Infanta Elena, Huelva, Spain
BMC Women's Health 2011, 11:36 doi:10.1186/1472-6874-11-36Published: 4 August 2011
Information concerning lipid disturbances in HIV-infected women on antiretroviral therapy (ART) is scarce. The objective of the study is to describe the lipid profile in a large cohort of HIV-infected women on contemporary ART and analyse differences between regimes and patient's characteristics.
Observational, multicentre, cross-sectional study from the Spanish VACH Cohort. 922 women on stable ART without lipid-lowering treatment were included.
Median age was 42 years, median CD4 lymphocyte count was 544 cells/mm3, and 85.6% presented undetectable HIV-1 viral load. Median total cholesterol (TC) was 189 mg/dL (interquartile range, IQR, 165-221), HDL cholesterol 53 mg/dL (IQR, 44-64), LDL cholesterol 108 mg/dL (IQR, 86-134), and triglycerides 116 mg/dL (IQR, 85-163). Mean accumulated time on ART was 116 months; 47.4% were on NNRTI-based regimes, 44.7% on PI, and 6.7% on only-NRTI therapy. 43.8% were also hepatitis C (HCV) coinfected. Patients on PI treatment presented higher TC/HDL ratio than those on NNRTI (p < 0.001). Significantly higher HDL values were observed in NNRTI-treated patients. HCV-coinfected patients presented lower TC/HDL ratio than the non HCV-coinfected. In multivariate analysis, factors independently associated with TC/HDL ratio were age, triglyceride levels and HCV co-infection. PI treatment presented a non-significant association with higher TC/HDL ratio.
In HIV-infected women, the NNRTI-based ART is associated with a better lipid profile than the PI-based. Factors unrelated to ART selection may also exert an independent, significant influence on lipids; in particular, age, and triglyceride levels are associated with an increased TC/HDL ratio while HCV co-infection is associated with a reduced TC/HDL ratio.