Gradual increases in dyslipidemia among male patients with human immunodeficiency virus primarily treated with tenofovir plus lamivudine plus efavirenz: a 3-year follow-up study

Abstract

Introduction: Since the development of antiretroviral therapy (ART) with TDF plus 3TC plus EFV, this specific regimen has not been studied enough with long-term lipid and uric monitoring.Methods: A prospective follow-up cohort study was performed. Sixty-one treatment-naive male patients with HIV were divided into three groups based on their baseline CD4+ T cell count (26, 12, and 23 patients in the <200, 200 to 350, and >350 groups, respectively). The lipid and purine metabolism parameters of the patients over 144 weeks were analyzed.Result: TG, TC, LDL-c and HDL-c levels all gradually increased over 144 weeks, but the increases in TC levels and HDL-c levels were significant (P=0.001, 0.000, respectively). Moreover, the percentages of hypercholesterolemia, hyper LDL cholesterolemia and hypertriglyceridemia all showed gradual and nonsignificant increases; the percentage of low HDL cholesterolemia showed a gradual and significant decrease (P=0.0007). Furthermore, the lower the baseline CD4+ T lymphocyte counts were, the higher the TG levels were and the lower the TC, LDL-c and HDL-c levels were. However, only baseline LDL-c levels differed significantly between the three groups (P=0.0457). Although the UA level and the percentages of hyperuricemia gradually increased over 144 weeks, there was no significant difference between the different follow-up time point groups or between the three CD4+ T cell count groups (all P>0.05). Further analyses revealed that the main factors contributing to lipid metabolism were age, anthropometric parameters and follow-up weeks, and virus load was the main factor contributing to uric acid levels.Conclusions: These findings provide a reference for clinicians to monitor lipid metabolism parameters closely during long-term ART with the TDF plus 3TC plus EFV regimen.