Lipoprotein particle subclasses, cardiovascular disease and HIV infection

Daniel A. Duprez, Lewis H. Kuller, Russell Tracy, James Otvos, David A. Cooper, Jennifer Hoy, Jacqueline Neuhaus, Nicholas I. Paton, Nina Friis-Moller, Fiona Lampe, Angelike P. Liappis, James D. Neaton

Research output: Contribution to journalArticlepeer-review

89 Scopus citations

Abstract

Objective: To study the association of lipoprotein particles with CVD in a subgroup of HIV-infected patients who were enrolled in the Strategies for Management of Anti-Retroviral Therapy (SMART) study. SMART was a trial of intermittent use of ART (drug conservation [DC]) versus continuous of ART (viral suppression [VS]). Methods: In a nested case-control study, lipoprotein particles (p) by nuclear magnetic resonance were measured at baseline and at the visit prior to the CVD event (latest levels) for 248 patients who had a CVD event and for 480 matched controls. Odds ratios (ORs) were estimated using conditional logistic models. Results: Total, large and small HDL-p, but not VLDL-p nor LDL-p, were significantly and inversely associated with CVD and its major component, non-fatal coronary heart disease. The HDL-p associations with CVD were reduced after adjustment for high sensitive C-reactive protein (hsCRP), interleukin-6 (IL-6) and D-dimer. Latest levels of total HDL-p were also significantly inversely associated with CVD; treatment interruption led to decrease of total HDL-p; adjusting for latest HDL-p did not explain the greater risk of CVD that was observed in the DC versus VS group. Conclusions: Lipoprotein particles, especially lower levels of small and large HDL-p identify HIV-infected patients at increased risk of CVD independent of other CVD risk factors.

Original languageEnglish (US)
Pages (from-to)524-529
Number of pages6
JournalAtherosclerosis
Volume207
Issue number2
DOIs
StatePublished - Dec 2009

Bibliographical note

Funding Information:
Support provided by: NIAD, NIH grants HL 090934-01, UO1AI068641, U01AI042170, U01AI46362. Clinical Trials gov. identifier: NCT00027352 . We would like to acknowledge the SMART participants, the SMART investigators (see Ref. [4, pp. 2294–2295] for list of investigators), and the INSIGHT Executive Committee.

Keywords

  • Atherosclerosis
  • Cardiovascular disease
  • Cholesterol
  • HDL- and LDL-cholesterol
  • HIV
  • Ischemic heart disease
  • Lipids
  • Lipoprotein particle size and number

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