Treatment of HIV infection with a raltegravir-based regimen increases LDL levels, but improves HDL cholesterol efflux capacity

Topic:

HIV Prevention

Authors:

Funderburg NT, Xu D, Playford MP, Joshi AA, Andrade A, Kuritzkes DR, Lederman MM, Mehta NN.

External Link:

Link to article

BACKGROUND:

Persons infected with HIV often have altered lipid profiles that may be affected by antiretroviral therapies (ART). Traditional lipid measurements may be insufficient to assess cardiovascular disease (CVD) risk in this population.

METHODS:

We report results from 39 ART-naïve participants in a substudy of A5248, a single-arm study of raltegravir (RAL), emtricitabine/tenofovir administration. Samples were collected at baseline, 12, 24, and 48 weeks after ART initiation. We performed advanced lipid phenotyping using nuclear magnetic resonance spectroscopy (NMR) spectroscopy (Liposcience, Raleigh, NC) for lipid particle size and number, and examined HDL function measuring reverse cholesterol transport using J774 macrophages.

RESULTS:

We report significant increases in total cholesterol (TC, 13 mg/dL; p<0.001) and low density lipoprotein (LDL, 8 mg/dL; p=0.03), with no change in triglycerides (TGs) and without an increase in LDL-particle number (p>0.1 all timepoints). High density lipoprotein (HDL) levels were increased over baseline levels at all timepoints (p<0.003), but reached a peak at week 12 and subsequently declined. HDL particle numbers also increased from baseline (p<0.002) and HDL function improved at week 48 (7% increase in efflux capacity; p<0.001). Oxidized LDL (oxLDL) levels decreased by week 12, but rose subsequently, and were not different from baseline at later timepoints.

CONCLUSIONS:

HDL increases were associated with increases in beneficial HDL particles and HDL cholesterol efflux capacity, which may reduce future CVD events. Persistent inflammation in these HIV+ participants, may be a cause, or consequence of oxLDL levels, and may contribute to declining levels of HDL over time.

Antivir Ther. 2016 Oct 14. doi: 10.3851/IMP3091. [Epub ahead of print]
PMID: 27740536

Categories

CRS
Topics

Clinical Trials

HPTN 078: Enhancing Recruitment, Linkage to Care and...

The purpose of this study is to develop and assess the efficacy of an integrated strategy that includes feasible and scalable...

Read More

A5342: Evaluating the Safety, Tolerability, and Effect of a...

The purpose of this study is to evaluate the safety, tolerability, and effect of an experimental human monoclonal antibody...

Read More

NWCS 445: Novel Biomarkers to Shorten TB Treatment

Objectives: Primary: To develop a highly predictive algorithm that identifies TB patients who will be cured by treatment...

Read More

A5354/EARLIER: Effect of Antiretroviral Treatment Initiated...

This study will include people who have very recently been infected with HIV and will start anti-HIV (antiretroviral) drugs...

Read More

NWCS 408: Examining Longitudinal Cytokine Profiles in HIV-TB...

Using existing data from A5274 and data obtained from retrospectively testing available biospecimens, we propose the following...

Read More