High-density lipoprotein concentrations relate to the clinical course of HIV viral load in patients undergoing antiretroviral therapy

Alonso-Villaverde, Carlos; Segues, T; Coll-Crespo, B; Pérez-Bernalte, R; Rabassa, Alfredo A.; Gomila, M; Parra, Sandra; Ma, Gozález-Esteban; Mj, Jiménez-Expósito; Masana, Luís

doi:10.1097/00002030-200305230-00009

Cited by 34 publications

(23 citation statements)

References 38 publications

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“…It has been suggested that a strong association between viral replication and both HDL [9,10,12] and host antioxidant defence [33][34][35] exists. The positive relationship between CD4 cell count and PON-1 activity suggests that higher PON-1 activity is associated with a better course of HIV infection and antiviral properties.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, levels of HDL-c have been significantly associated with a better HIV infection course [12]. Furthermore, it has been suggested that, instead of the current practice of only measuring HDL-c values, the evaluation of HDL quality might be an improved tool for identifying subjects at increased risk of cardiovascular events [13].…”

Section: Introductionmentioning

confidence: 99%

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Effect of efavirenz on high‐density lipoprotein antioxidant properties in HIV‐infected patients

Pereira

Batuca

Caixas

et al. 2009

Brit J Clinical Pharma

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WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• In previous work, we showed a long-term and concentration-dependent beneficial effect of the non-nucleoside reverse transcriptase inhibitor efavirenz (EFV) on high-density lipoproteins (HDL) in human immunodeficiency virus (HIV)-infected patients.• Furthermore, it has been suggested that instead of the current practice of only measuring HDL-chelesterol values, the evaluation of HDL function, namely its antioxidant properties, might be an improved tool for identifying subjects at increased risk for cardiovascular events.• Paraoxonase-1 (PON-1) is an enzyme associated with HDL that is responsible for HDL antioxidant function. WHAT THIS STUDY ADDS• In the present work, we studied the effect of EFV on the activity of PON-1 and showed, for the first time, that EFV-based antiretroviral therapy is associated with a better antioxidant function, i.e. with a higher PON-1 activity. AIMSA long-term and concentration-dependent beneficial effect of efavirenz (EFV) on cholesterol associated with high-density lipoprotein (HDL-c) in human immunodeficiency virus (HIV)-infected patients has been documented. Furthermore, it has been suggested that, instead of the current practice of only measuring HDL-c values, the evaluation of HDL quality might be an improved tool for identifying subjects at increased risk of cardiovascular events. Paraoxonase-1 (PON-1) is an enzyme associated with HDL that is involved in the onset of cardiovascular disease and responsible for HDL antioxidant function. The aim of the present study was to investigate the effect of EFV on the circulating activity of PON-1 in HIV-infected patients. METHODSThe patients included were adults with a documented HIV-1 infection, nontreated or treated with antiretroviral regimens including EFV 600 mg once daily as first therapeutic regimen for at least 3 months. The influence of treatment with EFV, HDL-c and CD4 cell count on PON-1 activity was analysed. RESULTSHIV-infected White patients treated with EFV had higher PON-1 activity [77.35 U l -1 (65.66, 89.04)] (P < 0.05) and higher PON-1 activity : HDL-c ratio [1.88 (1.49, 2.28)] (P < 0.01) than untreated patients. PON-1 activity was higher in Black patients (P < 0.001) and in patients with a CD4 cell count >500 cells ml -1 (P = 0.0120). CONCLUSIONSEFV-based antiretroviral regimens are associated with HDL particles with a better antioxidant function, i.e. with a higher PON-1 activity. The PON-1 activity of Black patients is higher than that found in Whites regardless of treatment. Ethnicity should be taken into consideration when studying drug effects on PON-1 activity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of efavirenz on high‐density lipoprotein antioxidant properties in HIV‐infected patients

Pereira

Batuca

Caixas

et al. 2009

Brit J Clinical Pharma

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“…Low high-density lipoprotein (HDL) cholesterol concentrations are common and characterize dyslipidaemia in patients undergoing long-term antiretroviral therapy [2], resulting in an increased incidence of cardiovascular events [3]. Consequently, clinical laboratories should provide accurate and reliable measurements of HDL cholesterol as part of the continuous management and evaluation of these patients [4].…”

Section: Introductionmentioning

confidence: 99%

Pitfalls in measuring high‐density lipoprotein cholesterol concentrations in HIV‐infected patients

et al. 2010

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Objectives HIV infection and its treatment are associated with dyslipidaemia and increased risk of cardiovascular disease. Accurate high‐density lipoprotein (HDL) cholesterol values are necessary for the management of these abnormalities, but current methods have not been properly assessed in these patients. The aim of this study was to assess in HIV‐infected patients the consistency and accuracy of a synthetic polymer/detergent homogeneous assay used to measure HDL cholesterol concentrations and to evaluate the impact of storage. Methods HDL cholesterol was measured using a synthetic polymer/detergent homogeneous method in samples from HIV‐infected patients and healthy subjects for each of the storage regimens: baseline, after 1 week at 4 °C, and after 12 months at −80 °C. The ultracentrifugation and precipitation assays were used for comparison. Results Three out of every 20 samples from HIV‐infected patients had discrepant HDL cholesterol values with respect to the ultracentrifugation method. Overestimation was associated with high C‐reactive protein concentrations and underestimation with plasma γ‐globulin concentrations, an effect that was amplified by any of the storage conditions tested. Conclusions Caution is needed when using the synthetic polymer/detergent homogeneous method for direct measurement of HDL cholesterol concentrations in HIV‐infected patients. This assay is of limited use in clinical trials in which frozen samples are analysed.

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“…These findings suggested that cholesterollowering therapy might represent a beneficial strategy for both preventing and treating HIV. Unfortunately, in vivo studies have been discouraging: three studies found no beneficial effect, while two other demonstrated that cholesterol-lowering therapy increased viral replication, particularly in individuals with low cellular cholesterol [4][5][6][7][8]. Furthermore, it was recently found that hypocholesterolemia [total cholesterol b150 mg/dl] was significantly associated with impaired viro-immune response in participants with and without HAART [9].…”

mentioning

confidence: 99%

“…A common view is that adenosine and several other mediators, released during the period of ischemia, play a seminal role in the phenomena, probably being linked to the activation of proliferative signal transduction systems [4]. There are also some theories to explain the development of myocardial stunning, of which the most plausible involve the oxygen paradox, the calcium paradox and the pH paradox [5].…”

mentioning

confidence: 99%

Cholesterol, vitamin D and cardiovascular prevention in HIV patients treated with antiretroviral therapy

Mascitelli¹,

Pezzetta²,

Goldstein³

2011

International Journal of Cardiology

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High-density lipoprotein concentrations relate to the clinical course of HIV viral load in patients undergoing antiretroviral therapy

Cited by 34 publications

References 38 publications

Effect of efavirenz on high‐density lipoprotein antioxidant properties in HIV‐infected patients

Effect of efavirenz on high‐density lipoprotein antioxidant properties in HIV‐infected patients

Pitfalls in measuring high‐density lipoprotein cholesterol concentrations in HIV‐infected patients

Cholesterol, vitamin D and cardiovascular prevention in HIV patients treated with antiretroviral therapy

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