PMID- 37181701 OWN - NLM STAT- MEDLINE DCOM- 20230516 LR - 20230523 IS - 2296-2565 (Electronic) IS - 2296-2565 (Linking) VI - 11 DP - 2023 TI - The effects of ART on the dynamics of lipid profiles in Chinese Han HIV-infected patients: comparison between NRTI/NNRTI and NRTI/INSTI. PG - 1161503 LID - 10.3389/fpubh.2023.1161503 [doi] LID - 1161503 AB - INTRODUCTION: This article aimed to compare the prevalence of dyslipidemia and determine risk factors associated with lipid levels in a cohort of HIV-infected patients receiving two different antiretroviral therapy (ART) regimens, nucleoside reverse transcriptase inhibitor/non-nucleoside reverse transcriptase inhibitor (NRTI/NNRTI) and nucleoside reverse transcriptase inhibitor/integrase strand transfer inhibitor (NRTI/INSTI). METHODS: This longitudinal study analyzed 633 HIV-infected patients with complete blood lipid profile records for at least 1 year at the ART clinic of Zhongnan Hospital of Wuhan University, China, from June 2018 to March 2021. Demographic and clinical data, including age, gender, body weight, height, current/former/non-smoker, current drinker, diabetes mellitus, hypertension, were extracted from electronic medical records. Laboratory tests included hematology, total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), Lipoprotein(a) and CD4 cell count. The observation duration of this study was a maximum of 33 months. Data comparisons were performed using the Chi-square test, Student's t-test and Mann-Whitney U test. Generalized linear mixed-effects model (GLMM) and value of p < 0.05 were used to determine factors associated with serum lipid profiles. RESULTS: In this study, the effect of the NNRTIs group on the lipid profile over time was mainly an increase in TC and HDL-C, while a decrease in TC/HDL-C and LDL/HDL-C. However, the INSTIs group had higher mean TC and lower HDL-C compared to the NNRTIs group, with significantly increased levels of TC, TG, HDL-C, and LDL-C. In the analysis of dyslipidemia rates, there were significant differences in the prevalence of abnormal TG and TC/HDL-C in HIV-infected patients receiving two different ART regimen groups during different follow-up periods. Dyslipidemia, defined as hypercholesterolemia, hypertriglyceridemia, and low HDL-C, was more prevalent in the INSTIs group, with a higher risk of developing hypertriglyceridemia and a higher TC/HDL-C ratio compared to the NNRTIs group. GLMM analysis suggested significantly higher TG values in the INSTIs group (estimated 0.36[0.10, 0.63], SE 0.14, p = 0.008) compared to the NNRTIs group, even after adjusting for other covariates. In addition, GLMM analysis also showed that age, gender, BMI, CD4 count, and ART duration were associated with dyslipidemia. CONCLUSION: In conclusion, treatment with both commonly-used ART regimens can increase the mean values of lipid profiles and the risk of dyslipidemia. The findings indicated that TG values were significantly higher in the INSTIs group than in HIV-infected patients receiving the NNRTIs regimens. Longitudinal TG values are independently associated with the clinical types of ART regimens.Clinical Trial Number: ChiCTR2200059861. CI - Copyright (c) 2023 Liu, Wei, Liang, Chen, Deng, Zhao and Wan. FAU - Liu, Shengnan AU - Liu S AD - Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China. FAU - Wei, Baozhu AU - Wei B AD - Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China. FAU - Liang, Wei AU - Liang W AD - School of Health Sciences, Wuhan University School of Health Sciences, Wuhan, China. FAU - Chen, Tielong AU - Chen T AD - Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, China. FAU - Deng, Liping AU - Deng L AD - Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, China. FAU - Zhao, Min AU - Zhao M AD - Demonstration Center for Experimental Basic Medicine Education, School of Basic Medical Sciences, Wuhan University, Wuhan, China. FAU - Wan, Jing AU - Wan J AD - Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20230427 PL - Switzerland TA - Front Public Health JT - Frontiers in public health JID - 101616579 RN - 0 (Reverse Transcriptase Inhibitors) RN - 0 (Cholesterol, LDL) RN - 0 (Triglycerides) RN - 0 (Lipids) SB - IM MH - Humans MH - Reverse Transcriptase Inhibitors/adverse effects MH - Longitudinal Studies MH - Cholesterol, LDL MH - East Asian People MH - *HIV Infections/drug therapy/epidemiology/complications MH - Triglycerides MH - Lipids MH - *Dyslipidemias/epidemiology MH - *Hypertriglyceridemia/epidemiology/chemically induced/complications PMC - PMC10174832 OTO - NOTNLM OT - HIV OT - INSTIs OT - NNRTIs OT - antiretroviral therapy OT - generalized linear mixed-effects model OT - lipid profile COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2023/05/14 19:13 MHDA- 2023/05/16 06:42 PMCR- 2023/04/27 CRDT- 2023/05/14 12:22 PHST- 2023/02/08 00:00 [received] PHST- 2023/03/30 00:00 [accepted] PHST- 2023/05/16 06:42 [medline] PHST- 2023/05/14 19:13 [pubmed] PHST- 2023/05/14 12:22 [entrez] PHST- 2023/04/27 00:00 [pmc-release] AID - 10.3389/fpubh.2023.1161503 [doi] PST - epublish SO - Front Public Health. 2023 Apr 27;11:1161503. doi: 10.3389/fpubh.2023.1161503. eCollection 2023.