Lipid and Apoprotein Profile in HIV-1-Infected Patients... : JAIDS Journal of Acquired Immune Deficiency Syndromes (original) (raw)

Brief Report: Clinical Science

Lipid and Apoprotein Profile in HIV-1-Infected Patients After CD4-Guided Treatment Interruption

Seoane, Elena MD, PhD*; Resino, Salvador PhD*†; Micheloud, Dariela MD, PhD*; Moreno, Ana MD‡; de Quiros, Juan C. L Bernaldo MD, PhD§; Lorente, Raquel*; Rubio, Rafael MD, PhD∥; Gonzalez, Juan MD, PhD¶; Pulido, Federico MD, PhD∥; Arribas, José R MD, PhD¶; Moreno, Santiago MD, PhD‡; Muñoz-Fernández, Má MD, PhD*

From the *Laboratorio de Inmuno-Biología Molecular, Hospital General Universitario “Gregorio Marañón,” Madrid, Spain; †Unidad de Investigación, Instituto de Salud Carlos III, Majadahonda, Spain; ‡Enfermedades Infecciosas, Hospital Universitario “Ramón y Cajal,” Madrid, Spain; §Enfermedades Infecciosas/VIH, Hospital Universitario “Gregorio Marañón,” Madrid, Spain; ∥Unidad de Infección VIH, Hospital Universitario “12 de Octubre,” Madrid, Spain; and the ¶Enfermedades Infecciosas, Hospital Universitario “La Paz,” Madrid, Spain.

Received for publication August 16, 2007; accepted March 13, 2008.

Supported by grants from Fondos de Investigación Sanitaria del Ministerio de Sanidad y Consumo (PI052476, PI061479); Red Tema´tica Cooperativa de Investigacioń en SIDA (RID) RD06-0006-0035; FIPSE (36514/05, 24534/05), Fundación Caja Navarra, and Comunidad de Madrid (S-SAL-0159-2006) to M.Á. M-F. From Fondos de Investigación Sanitaria (FIS) (PI052411, PI07/90201) and Fundación para la Investigación y la Prevención del SIDA en España (FIPSE) (36650/07) to S.R.

The authors do not have commercial or other associations that might pose a conflict of interest.

M. A. M. F. and S. M. have equally contributed to this work.

Correspondence to: Ma Ángeles Muñoz-Fernández, MD, PhD, Laboratorio de Inmuno-Biología Molecular, Hospital General Universitario “Gregorio Marañón,” C/Doctor Esquerdo 46, 28007, Madrid, Spain (e-mail: [email protected]).

Abstract

Objectives:

The aims of the present study were to determine if metabolic abnormalities and cytokine derangements are modified in HIV-1-infected patients after 12 months on treatment interruption (TI).

Design:

The design of this study was prospective randomized study.

Methods:

Longitudinal multicenter study in HIV-1-infected patients with a 12-month follow-up. Patients on stable highly active antiretroviral therapy, with CD4 count >600/μL and HIV RNA <50 copies/mL for at least 6 months, were randomized to interrupt therapy or continue ongoing highly active antiretroviral therapy. Lipids (total cholesterol, triglycerides), apoproteins (A1, B, and E), and adipocytokines (leptin, adiponectin, plasminogen activator inhibitor-1, monocyte chemotactic protein-1, Interleukin-6, Interleukin-8, and tumor necrosis factor-α) were measured at baseline and at month 12. Multiplex suspension bead array immunoassay was performed using the Luminex 100 analyzer to identify protein expression in plasma.

Results:

Patients who underwent TI (n = 19) had a significant decrease in median cholesterol levels (P < 0.001), while median triglyceride levels remained unchanged. There was a significant decrease in Apo-A1 levels (P = 0.048) and Apo-B levels (P < 0.001) and an increase in tumor necrosis factor-α levels (P = 0.034). Given the greater decrease in Apo-B, the ratio Apo-A1/Apo-B increased after 12 months of TI (from 3.4 to 5.1, P = 0.008). We did not find significant variations in leptin or adiponectin levels. In patients who continued on highly active antiretroviral therapy (n = 18), there were no significant changes in any of the measured parameters.

Conclusion:

The lipid profile and apoproteins levels change toward a less atherogenic profile after TI, arguing against a lipid-mediated mechanism to explain the increased cardiovascular risk in patients who interrupt treatment.