Lipoprotein levels and cardiovascular risk in HIV-infected and uninfected Rwandan women

Abstract

BackgroundLipoprotein profiles in HIV-infected African women have not been well described. We assessed associations of lipoprotein levels and cardiovascular risk with HIV-infection and CD4 count in Rwandan women.MethodsCross-sectional study of 824 (218 HIV-negative, 606 HIV+) Rwandan women. Body composition by body impedance analysis, CD4 count, and fasting serum total cholesterol (total-C), triglycerides (TG) and high-density lipoprotein (HDL) levels were measured. Low-density lipoprotein (LDL) was calculated from Friedewald equation if TG < 400 and measured directly if TG ≥ 400 mg/dl.ResultsBMI was similar in HIV+ and -negative women, < 1% were diabetic, and HIV+ women were younger. In multivariate models LDL was not associated with HIV-serostatus. HDL was lower in HIV+ women (44 vs. 54 mg/dL, p < 0.0001) with no significant difference by CD4 count (p = 0.13). HIV serostatus (p = 0.005) and among HIV+ women lower CD4 count (p = 0.04) were associated with higher TG. BMI was independently associated with higher LDL (p = 0.01), and higher total body fat was strongly associated with higher total-C and LDL. Framingham risk scores were < 2% in both groups.ConclusionsIn this cohort of non-obese African women HDL and TG, but not LDL, were adversely associated with HIV infection. As HDL is a strong predictor of cardiovascular (CV) events in women, this HIV-associated difference may confer increased risk for CV disease in HIV-infected women.

Influence of <i>Moringa oleifera</i> leaves on atherogenic lipids and glycaemia evolution in HIV-infected and uninfected malnourished patients

“…Indeed, HIV infection and antiretroviral drugs have independent noxious effects on the blood-vessels and in association, their impact are significantly worsened (Pontes-Cardoso et al, 2007;Bernal et al, 2008). The reduction of HDL-C in HIV positive of this study confirms report of Bernal et al, (2008), Anastos et al, (2010) and would be due partly to Apo A1 synthesis reduction (Tété-Bénissan et al, 2011), because of immunity collapse (Crowe et al, 2010). In this study, increase of triglycerides in HIV positive is in agreement with report of former studies (Presles, 2006;Pontes-Cardoso et al, 2007;Cournil et al, 2011) which showed that hypertriglyceridemia would be explained by cholesterol and triglycerides transport as lipoproteins.…”

“…The important decrease of total cholesterol (hypocholesterolemia) observed among HIV positive patients was induced by pro inflammatory cytokines (interleukines, INF and TNF) accelerating esterified cholesterol accumulation in activated macrophages (Sawadogo et al, 2005;Crowe et al, 2010;Tété-Bénissan et al, 2011). About significant increase of total cholesterol in HIV positive treated with ARV drugs; it was already highlighted by several studies and would be due to a more important disturbance of lipids metabolism (Presles, 2006;Bernal et al, 2008;Anastos et al, 2010;Melzi et al, 2010). Indeed, HIV infection and antiretroviral drugs have independent noxious effects on the blood-vessels and in association, their impact are significantly worsened (Pontes-Cardoso et al, 2007;Bernal et al, 2008).…”

“…Acute infections and HIV involve lipids metabolism disturbances and increase cardiovascular diseases risks in patients (Sawadogo et al, 2005;Presles, 2006;Bernal et al, 2008;Crowe et al, 2010). Moreover, antiretroviral therapy of people living with HIV/AIDS, increases coronary diseases frequency and myocardial infarction risk (Bernal et al, 2008;Malvestutto & Aberg, 2010;Anastos et al, 2010;Melzi et al, 2010;Cournil et al, 2011). Antiretroviral therapy associated with protease inhibitors could provoke insulin resistance and type 2 diabetes development in immunodeficiency patients (Yoon, 2005;Vyas et al, 2010).In Togo, approximately 30% of children are undernourished and among them 23.5% who are under five years present growth retardation and 14.3% are affected by acute form of malnutrition (Ministry of Health, 2009).…”

Incidence and prevalence of type 2 diabetes mellitus with HIV infection in Africa: a systematic review and meta-analysis

“…After screening, 20 articles met the eligibility criteria [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] and were included in the analysis (figure 1). Of these, seven 17-23 articles reported incidence of T2DM in HIV-infected participants, eight 24-31 reported prevalence of T2DM in HIV-infected participants compared with uninfected controls and five 32-36 reported prevalence of T2DM in HIV-infected participants on treatment compared with untreated controls.…”

Assessment of haematological parameters in HIV-infected and uninfected Rwandan women: a cross-sectional study

“…Details of the RWISA study procedures and informed consent process including video and individual discussion have been previously described. 16 Laboratory data CD4 T lymphocytes counts were determined using the Becton Dickinson FASCount system (Becton Dickinson, Singapore) at the National Reference Laboratory, Kigali, Rwanda and full blood count analyses were performed at King Faisal Hospital in Kigali using CELL-DYN 1800 automated blood analyser (Abbott). A modified methaemoglobin method was used for the colorimetric determination of haemoglobin (Hb).…”