Lipid profile of HIV-infected patients in relation to antiretroviral therapy: a review

Revista da Associação Médica Brasileira

Suelen Jorge Souza²  Liania Alves Luzia²  Sigrid Sousa Santos¹  Patrícia Helen Carvalho Rondó² 

[1] ,Universidade de São Paulo School of Public Health Nutrition DepartmentSão Paulo SP ,Brazil

关键词: Human Immunodeficiency Virus;    Acquired Immunodeficiency;    Syndrome;    Antiretroviral therapy;    Highly active antiretroviral therapy;    Dyslipidemia;    Vírus da Imunodeficiência Humana;    Síndrome da Imunodeficiência;    Adquirida;    Terapia antirretroviral;    Terapia antirretroviral de alta potência;    Dislipidemia;   

DOI  :  10.1016/j.ramb.2012.11.003

来源: SciELO

【 摘 要 】

This study reviewed the lipid profile of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients in relation to use of antiretroviral therapy (ART), and its different classes of drugs. A total of 190 articles published in peer-reviewed journals were retrieved from PubMed and LILACS databases; 88 of them met the selection criteria and were included in the review. Patients with HIV/AIDS without ART presented an increase of triglycerides and decreases of total cholesterol, low density lipoprotein (LDL-c), and high density lipoprotein (HDL-c) levels. Distinct ART regimens appear to promote different alterations in lipid metabolism. Protease inhibitors, particularly indinavir and lopinavir, were commonly associated with hypercholesterolemia, high LDL-c, low HDL-c, and hypertriglyceridemia. The protease inhibitor atazanavir is apparently associated with a more advantageous lipid profile. Some nucleoside reverse-transcriptase inhibitors (didanosine, stavudine, and zidovudine) induced lipoatrophy and hypertriglyceridemia, whereas abacavir increased the risk of cardiovascular diseases even in the absence of apparent lipid disorders, and tenofovir resulted in lower levels of cholesterol and triglycerides. Although non-nucleoside reverse-transcriptase inhibitors predisposed to hypertriglyceridemia and hypercholesterolemia, nevirapine was particularly associated with high HDL-c levels, a protective factor against cardiovascular diseases. Therefore, the infection itself, different classes of drugs, and some drugs from the same class of ART appear to exert distinct alterations in lipid metabolism.

【 授权许可】

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