Evolution of blood lipids and risk factors of dyslipidemia among people living with human immunodeficiency virus who had received first-line antiretroviral regimens for 3 years in Shenzhen

Sun, Li-Qin1; Liu, Jia-Ye2; He, Yun1; Zhou, Yang1; Xu, Liu-Mei1; Zhang, Lu-Kun1; Zhao, Fang1; Liu, Xiao-Ning1; Song, Ying1; Cao, Ting-Zhi1; Tian, Yi-Mei1; Rao, Man1; Wang, Hui1

2020-12-05

10.1097/CM9.0000000000001245

CHINESE MEDICAL JOURNAL   影响因子和分区

0366-6999

2542-5641

Background Lipid abnormalities are prevalent among people living with human immunodeficiency virus (HIV) (PLWH) and contribute to increasing risk of cardiovascular events. This study aims to investigate the incidence of dyslipidemia and its risk factors in PLWH after receiving different first-line free antiretroviral regimens. Methods PLWH who sought care at the Third People's Hospital of Shenzhen from January 2014 to December 2018 were included, and the baseline characteristics and clinical data during the follow-up were collected, including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). The risk factors of dyslipidemia after antiretroviral therapy were analyzed with the generalized estimating equation model. Results Among the 7623 PLWH included, the mean levels of TC, HDL-C and LDL-C were 4.23 +/- 0.85 mmol/L, 1.27 +/- 0.29 mmol/L and 2.54 +/- 0.65 mmol/L, respectively, and the median TG was 1.17 (IQR: 0.85-1.68) mmol/L. Compared with that in PLWH receiving tenofovir disoproxil fumarate (TDF) + lamivudine (3TC) + ritonavir-boosted lopinavir (LPV/r), zidovudine (AZT) + 3TC + efavirenz (EFV), and AZT + 3TC + LPV/r, the incidence of dyslipidemia was lower in PLWH receiving TDF + 3TC + EFV. In multivariate analysis, we found that the risks of elevations of TG, TC, and LDL-C were higher with TDF + 3TC + LPV/r (TG: odds ratio [OR] = 2.82, 95% confidence interval [CI]: 2.55-3.11, P < 0.001; TC: OR = 1.24, 95% CI: 1.14-1.35, P < 0.001; LDL: OR = 1.06, 95% CI: 1.00-1.12, P = 0.041), AZT + 3TC + EFV (TG: OR = 1.41, 95% CI: 1.28-1.55, P < 0.001; TC: OR = 1.43, 95% CI: 1.31-1.56, P < 0.001; LDL: OR = 1.18, 95% CI: 1.12-1.25, P < 0.001), and AZT + 3TC + LPV/r (TG: OR = 3.08, 95% CI: 2.65-3.59, P < 0.001; TC: OR = 2.40, 95% CI: 1.96-2.94, P < 0.001; LDL: OR = 1.52, 95% CI: 1.37-1.69, P < 0.001) than with TDF + 3TC + EFV, while treatment with TDF + 3TC + LPV/r was less likely to restore HDL-C levels compared with TDF + 3TC + EFV (OR = 0.95, 95% CI: 0.92-0.97, P < 0.001). In addition to antiretroviral regimens, antiretroviral therapy duration, older age, overweight, obesity and other traditional factors were also important risk factors for dyslipidemia. Conclusion The incidence of dyslipidemia varies with different antiretroviral regimens, with TDF + 3TC + EFV having lower risk for dyslipidemia than the other first-line free antiretroviral regimens in China.

Antiretroviral therapy Dyslipidemia Metabolic syndrome Non-nucleoside reverse transcriptase inhibitor Nucleoside reverse transcriptase inhibitor Protease inhibitor

SCI

英语

第一 ; 通讯

Sanming Project of Medicine in Shenzhen[SZSM201612014][SZSM201512029] ; Guangdong Basic and Applied Basic Research Foundation[2019A1515011197] ; Science and Technology Innovation Committee of Shenzhen Municipality[JCYJ20190809115617365]

General & Internal Medicine

Medicine, General & Internal

WOS:000595175800007

LIPPINCOTT WILLIAMS & WILKINS

CLINICAL MEDICINE

Web of Science

1.Southern Univ Sci & Technol, Peoples Hosp Shenzhen 3, Dept Infect Dis, Affiliated Hosp 2, Shenzhen 518100, Guangdong, Peoples R China
2.Southern Univ Sci & Technol, Peoples Hosp Shenzhen 3, Natl Clin Res Ctr Infect Dis, Affiliated Hosp 2, Shenzhen 518100, Guangdong, Peoples R China

Sun, Li-Qin,Liu, Jia-Ye,He, Yun,et al. Evolution of blood lipids and risk factors of dyslipidemia among people living with human immunodeficiency virus who had received first-line antiretroviral regimens for 3 years in Shenzhen[J]. CHINESE MEDICAL JOURNAL,2020,133(23):2808-2815.

Sun, Li-Qin.,Liu, Jia-Ye.,He, Yun.,Zhou, Yang.,Xu, Liu-Mei.,...&Wang, Hui.(2020).Evolution of blood lipids and risk factors of dyslipidemia among people living with human immunodeficiency virus who had received first-line antiretroviral regimens for 3 years in Shenzhen.CHINESE MEDICAL JOURNAL,133(23),2808-2815.

Sun, Li-Qin,et al."Evolution of blood lipids and risk factors of dyslipidemia among people living with human immunodeficiency virus who had received first-line antiretroviral regimens for 3 years in Shenzhen".CHINESE MEDICAL JOURNAL 133.23(2020):2808-2815.