The risk of dyslipidemia on PLHIV associated with different antiretroviral regimens in Huzhou

• Published in: PloS one 2024-09, Vol.19 (9), p.e0305461
• Main Authors: Wang, Yanan, Yang, Zhongrong, Li, Jing, Wu, Zhenqian, Liu, Xiaoqi, Wang, Hui, Chen, Yuxin, Wang, Ziyi, Tong, Zhaowei, Li, Xiaofeng, Ren, Feilin, Jin, Meihua, Mao, Guangyun
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adult; AIDS; Alkynes; Anti-HIV Agents - adverse effects; Anti-HIV Agents - therapeutic use; Antiretroviral agents; Antiretroviral Therapy, Highly Active - adverse effects; Benzoxazines - administration & dosage; Benzoxazines - adverse effects; Benzoxazines - therapeutic use; Blood; Cardiovascular disease; Cardiovascular diseases; Care and treatment; Caregivers; China - epidemiology; Cholesterol; Confidence intervals; Creatinine; Cyclopropanes; Diabetes; Diabetes mellitus; Disease prevention; Dyslipidemia; Dyslipidemias - chemically induced; Dyslipidemias - epidemiology; Efavirenz; Estimation; Evaluation; Female; Health aspects; Health risks; High density lipoprotein; Highly active antiretroviral therapy; HIV; HIV (Viruses); HIV Infections - complications; HIV Infections - drug therapy; Human immunodeficiency virus; Humans; Lamivudine; Lamivudine - adverse effects; Lamivudine - therapeutic use; Life expectancy; Lipid metabolism; Lipids; Male; Metabolic disorders; Middle Aged; Patient outcomes; Prevalence; Quality of life; Regression models; Risk Factors; Statistical analysis; Tenofovir; Tenofovir - adverse effects; Tenofovir - therapeutic use; Triglycerides; Zidovudine; Zidovudine - adverse effects; Zidovudine - therapeutic use
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0305461

Dyslipidemia is increasingly common in people living with HIV (PLHIV), thereby increasing the risk of cardiovascular events and diminishing the quality of life for these individuals. The study of blood lipid metabolism of PLHIV has great clinical significance in predicting the risk of cardiovascular disease. Therefore, this study aims to examine the blood lipid metabolism status of HIV-infected patients in Huzhou before and after receiving highly active antiretroviral therapy (HAART) and to explore the impact of different HAART regimens on dyslipidemia. PLHIV confirmed in Huzhou from June 2010 to June 2022 was included. The baseline characteristics and clinical data during the follow-up period were collected, including some blood lipid indicators (total cholesterol and triglycerides) and HAART regimens. A multivariate logistic regression model and the generalized estimating equation model were used to analyze the independent effects of treatment regimens on the risk of dyslipidemia. The overall prevalence of dyslipidemia among PLHIV after HAART was 70.11%. PLHIV receiving lamivudine (3TC) + efavirenz (EFV) + zidovudine (AZT) had a higher prevalence of dyslipidemia compared to those receiving 3TC+EFV+tenofovir disoproxil fumarate (TDF). In a logistic analysis adjusted for important covariates such as BMI, age, diabetes status, etc., we found that the risks of dyslipidemia were higher with 3TC+EFV+AZT (dyslipidemia: odds ratio [OR] = 2.09, 95% confidence interval [Cl]: 1.28-3.41; TG ≥1.7: OR = 2.40, 95%Cl:1.50-3.84) than with 3TC+EFV+TDF. Furthermore, on PLHIV that was matched 1:1 by the HAART regimens, the results of the generalized estimation equation again showed that 3TC+EFV+AZT (TG ≥1.7: OR = 1.84, 95%Cl: 1.10-3.07) is higher for the risk of marginal elevations of TG than 3TC+EFV+TDF. The prevalence of dyslipidemia varies according to different antiretroviral regimens. Using both horizontal and longitudinal data, we have repeatedly demonstrated that AZT has a more adverse effect on blood lipids than TDF from two perspectives. Therefore, we recommend caution in using the 3TC+EFV+AZT regimen for people at clinical risk of co-occurring cardiovascular disease.