Lipids profile among ART-naïve HIV infected patients and men who have sex with men in China: a case control study

Abstract

BackgroundDyslipidemia is commonly seen in human immunodeficiency virus (HIV) infected patients. Understanding the risk factors of abnormal lipid profiles is urgent for proposing targeted approaches to prevention. Our objective was to assess the incidence and associated factors of abnormal lipid profiles and atherogenic index of plasma (AIP) among antiretroviral therapy (ART) naïve men who have sex with men (MSM) acute HIV infection (AHI) and chronic HIV infection (CHI) patients in China.MethodsWe compared lipids parameters such as triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and AIP between MSM HIV-infected patients and MSM HIV negative controls. Multivariable linear regression was used to evaluate risk factors of higher AIP.ResultsWe performed a case control analysis of 110 AHI, 110 CHI and 100 HIV negative MSM participants. The TC, HDL-C and LDL-C levels were decreased in the AHI and CHI groups compared to the controls (3.90 ± 0.73 mmol/L and 3.72 ± 0.74 mmol/L versus 4.49 ± 0.91 mmol/L, p < 0.001; 1.00 ± 0.25 mmol/L and 1.01 ± 0.30 mmol/L versus 1.19 ± 0.29 mmol/L, p < 0.001; 2.11 ± 0.57 mmol/L and 2.22 ± 0.58 mmol/L versus 2.75 ± 0.78 mmol/L, p < 0.001). The AIP score was higher in the AHI patients compared to the control group [0.08 (−0.05–0.20) versus−0.04 (−0.21–0.22), p = 0.039]. In total groups, AIP was associated with AHI and TG positively (β = 0.029 ± 0.012, p = 0.015;β = 0.273 ± 0.009, p < 0.001) and correlated with HDL-C inversely (β = -0.444 ± 0.023, p < 0.001).ConclusionsHIV infection contributed to decreased TC, LDL-C and HDL-C. AHI contributed to higher AIP level. An urgent need exists for earlier HIV diagnosis and better prevention of dyslipidemia in China.

Cardiovascular Disease and Cardiovascular Disease Risk in HIV-Positive Populations in the Asian Region

“…Several studies from the Asian region showed that dyslipidaemia was less prevalent in patients who were first presented with HIV compared to their HIV negative counterparts [ 19 , 20 ]. Cholesterol levels were on average lower in HIV positive patients [ 19 - 22 ], whereas findings were inconsistent regarding triglyceride levels [ 19 - 21 ].…”

“…In Malaysia, dyslipidaemia was reported in 82% of patients on ART [ 23 ]. Other evidence from the Asian region indicated abnormal levels of triglycerides, TC, LDL and HDL in 7-39%, 3-8%, 2-17% and 19-86% of ART naïve patients, respectively [ 19 - 22 , 24 - 26 ], compared to 39-54%, 26-54%, 22-48% and 14-68% of ART experienced patients, respectively [ 15 , 19 , 20 , 23 - 27 ].…”

“…Additional information on diabetes and blood glucose levels was available from other Asian countries. In China, blood glucose levels were higher in HIV positive than HIV negative men [ 22 ]. Furthermore, 20% of Chinese ART-naïve patients had elevated blood glucose levels, of whom 11% met the criteria for diabetes [ 32 ].…”

“…There is inconclusive evidence from the Asian region regarding hypertension and differences across HIV or ART status. For example, no significant differences were found between HIV negative and positive men in China [ 22 ]. In addition, ART naïve patients in India had a relatively low prevalence of hypertension (12%) compared to HIV negative individuals (36%) and ART experienced patients (17%, p=0.002) [ 19 ].…”

“…Across the Asian region, the proportion of current smokers ranged from 23-62% [ 15 , 22 , 39 - 41 ] and that of former smoker from 10-20% [ 15 , 40 ]. One study specifically compared smoking among Asian populations on ART and found that compared to Thailand, the prevalence of smoking was lower in India and the Philippines, while it was higher in Vietnam, Indonesia, Hong Kong, Taiwan, Malaysia, Japan, South Korea and Singapore [ 15 ].…”