Dyslipidemie indukovaná antiretrovirovými léčivy

Title in English Dyslipidaemia inducted by antiretroviral agents
Authors

SNOPKOVÁ Svatava POVOLNÁ Kateřina HUSA Petr JARKOVSKÝ Jiří PAVLÍK Tomáš

Year of publication 2008
Type Article in Periodical
Magazine / Source Vnitřní lékařství
MU Faculty or unit

Faculty of Medicine

Citation
Field Immunology
Keywords HIV; HAART; dyslipidaemia; cardiovascular risk
Description The clinical course of HIV/AIDS has been substantially modified by up-to date therapy in the recent years. The progress of the disorder has changed - today it is chronic disease of many years course. Already in 1997 and 1998 it turned out that adverse metabolic changes which significantly affect the subsequent progress of the disease were produced by long-term HAART. Gradually, more and more anthropometric, metabolic and coagulation changes are detected, closely resembling the changes seen in the metabolic syndrome, well known from cardiology and internal medicine - dyslipoproteinaemia, insulin resistance, abdominal obesity and so on. A combination of these disorders is clinically significant due to their role in atherosclerosis and their involvment in the onset of ischaemic heart disease. In view of the much lower average age of HIV-positive individuals the earlier mentioned complications should be expected in much lower age categories than with HIV-negative individuals. Plasma lipid fractions (total cholesterol, triglycerides, LDL-cholesterol, HDL-cholesterol, apoA-I, apoB, LDL/HDL, apoA-I/apoB) have been investigated in 69 HIV infected subjects and the changes of these parameters in the course of progression of HIV/AIDS due to cumulative time of exposure to HAART were explored. Significant increase of the level of proatherogenic plasma lipid fractions with tendency to develop at time course was found. These disturbances are observed in the course of very good immunological stabilization and viral supression. No unambiguaous data and results of long-term studies are available, that would confirm the increase of cardiovascular risk in HIV infected subjects. Nevertheless, this increase is required and anticipated.
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