Atherosclerosis 187 (2006) 177–185 Age and sex modulate metabolic and cardiovascular risk markers of patients after 1 year of highly active antiretroviral therapy (HAART) Judith Maria Leitner a , Heidemarie Pernerstorfer-Schoen b,c , Alina Weiss d , Karin Schindler b , Armin Rieger b , Bernd Jilma a,∗ a Department of Clinical Pharmacology, Division of Immunohaematology, Universit¨ atsklinik f ¨ ur Klinische Pharmakologie, Medical University of Vienna, Austria b Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases, Medical University of Vienna, Vienna, Austria c Fourth Medical Department, Division of Dermatology, Hanusch Hospital, Vienna, Austria d Department of Dermatology, Lainz Hospital, Vienna, Austria Received 23 March 2005; received in revised form 1 September 2005; accepted 1 September 2005 Available online 3 October 2005 Abstract Objective: Primary aim: To evaluate the modulating effects of age and sex on changes in plasma lipid levels in the response to highly active antiretroviral therapy (HAART). Secondary aim: To study insulin, leptin, adiponectin, E-selectin and P-selectin levels and their relation to demographics. Design: Comparative, longitudinal, open cohort-study. Setting: Tertiary care center at a University Hospital. Methods: Eighty-two consecutive HIV-seropositive patients of either sex were enrolled in the study. Subjects were between 19 and 60 years of age and naive to HAART. Patients were treated with nucleoside reverse transcriptase inhibitors (NRTIs) and protease inhibitor(s) (PIs) or reverse transcriptase inhibitors (RTIs) only. Subjects were evaluated at baseline and after 3, 6 and 12 months. Results: Total cholesterol levels increased in all patients. The greatest increase was seen in patients of older age treated with PI. Male gender was another risk factor for higher cholesterol but also for higher triglyceride levels. Therapy with protease inhibitors and/or stavudine had a negative influence on plasma triglyceride levels. Selectins, adipokines and insulin were less influenced by HAART. Conclusion: Based on the results of this study selection of therapy regimen according to the demographic risk factors sex and age can offer an easy strategy to help to minimize lipid elevations. © 2005 Elsevier Ireland Ltd. All rights reserved. Keywords: HIV; Age; Sex; Adipocytokines; Selectins; Hyperlipidemia; Atherosclerosis 1. Introduction Metabolic alterations are common side-effects of highly active antiretroviral therapy (HAART). Increases in serum triglycerides, low-density lipoproteins (LDL) and total cholesterol have been reported as well as the development of insulin resistance [1,2]. The reports of dyslipidaemias in association with HAART have raised concerns about the associated long-term mor- ∗ Corresponding author. Tel.: +43 1 40400 2981; fax: +43 1 40400 2998. E-mail address: bernd.jilma@meduniwien.ac.at (B. Jilma). bidity and mortality in this patient group, particularly with respect to the risk of developing coronary heart disease (CHD) [3]. Most notably, AIDS-related events are no longer the major causes of death of HIV-infected patients in the era of HAART [4]. In addition to the routinely performed controls of lipid metabolism, it seems recommendable to establish new sur- rogate markers for cardiovascular risk evaluation in HIV- infected patients. Adhesion molecules, among other factors, appear to play an essential role in atherogenesis [5–7]. Epi- demiologic data in humans suggest that elevated plasma levels of E-selectin (endothelial-cell marker), P-selectin 0021-9150/$ – see front matter © 2005 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.atherosclerosis.2005.09.001