Open Access Research article

Dyslipidaemia in HIV-infected women on antiretroviral therapy. Analysis of 922 patients from the Spanish VACH cohort

Vicente Estrada1*, Paloma Geijo2, Manuel Fuentes-Ferrer3, María Luisa García Alcalde4, María Rodrigo5, María José Galindo6, Agustín Muñoz7, Pere Domingo8, Esteve Ribera9, Jaime Cosín10, Pompeyo Viciana11, Fernando Lozano12, Alberto Terrón13, Antonio Vergara14, Ramón Teira15, Josefa Muñoz-Sánchez16, Bernardino Roca17, Trinitario Sánchez18, José López-Aldeguer19, Elisabeth Deig20, Francisco Vidal21, Enric Pedrol22, Manuel Castaño-Carracedo23, Teresa Puig24, Myriam Garrido25 and Ignacio Suárez-Lozano26

Author affiliations

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

For all author emails, please log on.

Citation and License

BMC Women's Health 2011, 11:36  doi:10.1186/1472-6874-11-36

Published: 4 August 2011

Abstract

Background

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.

Methods

Observational, multicentre, cross-sectional study from the Spanish VACH Cohort. 922 women on stable ART without lipid-lowering treatment were included.

Results

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.

Conclusions

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.