American Journal of Medicine and Medical Sciences 2013, 3(3): 44-50
DOI: 10.5923/j.ajmms.20130303.02
Characterization of Lipid Panel in Hiv-1 Infected Patients:
A Study of Baseline and 52 Weeks Haart Patients
Osaretin Albert Taiwo Ebuehi
*
, Kennedy Madaki Idoko, Anthony Ani
Department of Biochemistry, College of Medicine, University of Lagos, Lagos, Nigeria
Abstract The study is to characterize lipid panels with an emphasis on HDL-C (high density lipoprotein cholesterol)
sub-fractions among HIV infected subjects in Lagos, Nigeria, in order to ascertain the pattern of alterations of these
parameters in patients on HAART (highly active antiretroviral therapy) for 52 weeks. Serum concentrations of HDL-C and
the HDL sub-fractions, HDL-C 2 and HDL-C 3, were measured in 20 HIV positive, HAART naïve and 20 HIV positive,
first-line HAART experienced subjects and compared with those of HIV negative control group matched for sex and age.
Serum total cholesterol (T-Chol) and low-density lipoprotein (LDL-C) levels were increased in HAART naïve patients and
decreased in HAART experienced patients as compared to controls. Triglycerides and fasting blood sugar levels were
significantly elevated in HAART naïve group in comparison with the other groups. Total HDL-C and HDL-C 3
concentrations were significantly lower in HAART naïve patients than in other groups while HDL-C 2 and HDL-C 2 /
HDL-C 3 ratio in contrast, were not significantly different among all the groups. It is suggested that quantitation of HDL-C
sub-fractions is not a valuable risk indicator for heart disease in HIV patients HAART naïve or experienced.
Keywords HIV-1 Infection, HAART, Lipid Panels
1. Introduction
High-density lipoprotein (HDL) is one of the five major
groups of lipoproteins which are chylomicrons, VLDL, IDL,
LDL, and HDL. These particles transport cholesterol and
triglycerides within the water-based bloodstream. Those
with higher levels of HDL-C seem to have fewer problems
with cardiovascular diseases, while those with low HDL-C
cholesterol levels (less than 40mg/dL or about 1mmol/L)
have increased rates for heart disease
1
. While higher HDL
levels are correlated with cardiovascular health, no
incremental increase in HDL has been proven to improve
health. The concentration value of HDL-cholesterol alone
gives no information about the coronary risk of a patient.
There are numerous reports that patients suffering from
atherosclerosis and myocardial infarction have lower
high-density lipoprotein (HDL) plasma concentrations as
compared to control individuals
2,3,4
. High HDL levels thus
point toward an active removal of the “atherosclerotic”
VLDL and VLDL remnants. There are, however, many other
theories discussed in that context. Since the hydrolysis of
VLDL gives rise mainly to the HDL sub-fraction HDL-2
5
,
this latter lipoprotein class should mirror more precisely the
activity of the lipolytic system than total HDL. The HDL-2
* Corresponding author:
ebuehi@yahoo.com (Osaretin Albert Taiwo Ebuehi)
Published online at http://journal.sapub.org/ajmms
Copyright © 2013 Scientific & Academic Publishing. All Rights Reserved
plasma concentrations thus may serve as a better risk
indicator than total HDL. The serum concentration of several
lip ids, including high-density lipoprotein-cholesterol
(HDL-C) and the HDL sub-fractions, HDL-2-C and
HDL-3-C, were measured in 44 male and 26 female
survivors of myocardial infarction and compared with those
of a control group matched for age, sex, and body weight.
Seru m concentrations of total cholesterol (TC) and
low-density lipoprotein (LDL-C) we re significantly
increased in patients as compared to control individuals. The
total HDL-C concentration was lower in patients than in
controls. By differential quantitation of HDL sub-fractions
with a precipitation method using polyethylene glycol, it was
found that HDL-3-C was not significantly different between
female patients and controls. The reduction of HDL-3-C in
male patients was only of borderline significance. HDL-2-C
in contrast was significantly reduced in both male and female
patients. The greatest difference between patients and
controls was found in the HDL-2/HDL-3-C ratio. It is
therefore concluded that HDL-2-C quantitation is a valuable
risk indicator for myocardial infarction yielding a better
discrimination of patients from controls than total HDL-C
quantitation
6
. Protease inhibitors (part of HAART) have
been shown to cause hyper- and dyslipoproteinemia. Since
antiretroviral therapy is able to delay disease progression and
possibly extend life expectancy in HIV-infected individuals,
the precise nature of serum lipid disturbances may become of
clinical interest with respect to its atherogenicity and to
finding treatment options. Berthold et al ., investigated