HDL biology
HIV infection is associated with elevated plasma CETP and LCAT alongside low HDL, without one-year progression of subclinical atherosclerosis (Atherosclerosis 2013)
Original title: The effect of HIV infection on atherosclerosis and lipoprotein metabolism: a one year prospective study
In a 12-month prospective study, treatment-naive HIV patients were assigned to untreated infection, NNRTI-based antiretroviral therapy, or protease-inhibitor-based therapy, with carotid intima-media thickness, pulse wave velocity, flow-mediated dilation, and lipoprotein metabolism assessed against published HIV-negative reference values. HIV patients had lower carotid intima-media thickness and flow-mediated dilation but higher pulse wave velocity than HIV-negative individuals, none of which changed significantly over 12 months. HIV patients also showed hypoalphalipoproteinemia alongside elevated plasma LCAT and CETP levels, though the only significant longitudinal lipid changes were total cholesterol and triglyceride elevation with protease-inhibitor therapy and LCAT elevation with NNRTI therapy; cholesterol efflux capacity was preserved across all groups, and the study found no evidence of rapid subclinical atherosclerosis progression within one year.
Original abstract
Objectives: HIV infection is associated with dyslipidaemia and increased risk of cardiovascular disease. The effects of HIV infection and antiretroviral treatment on surrogate markers of atherosclerosis, and lipoprotein metabolism were evaluated in a 12 month prospective study.
Methods And Results: Treatment-naive HIV patients were recruited into one of three groups: untreated HIV infection not likely to require initiation of antiretroviral therapy (ART) for at least 12 months; initiating treatment with non nucleoside reverse transcriptase inhibitor-containing ART regimen and initiating treatment with protease inhibitor-containing ART regimen. The patients underwent assessment of carotid intima-media thickness (cIMT), pulse wave velocity (PWV), brachial flow-mediated dilation (FMD) and variables of plasma lipoprotein metabolism at baseline and 12 months. The findings were compared with published values for age and sex matched HIV-negative healthy subjects in a cross-sectional fashion. cIMT and FMD were lower while PWV was higher in HIV-patients compared with HIV-negative individuals; none of the markers changed significantly during 12 months follow up. HIV patients had hypoalphalipoproteinemia and elevated plasma levels of lecithin:cholesterol acyltransferase (LCAT) and cholesteryl ester transfer protein. The only significant changes in lipid-related variables were elevation of total cholesterol and triglycerides in patients treated with PI-containing regimen and elevation of plasma LCAT levels in patients treated with NNRTI-containing regimen. The ability of whole and apoB-depleted plasma to effect cholesterol efflux was not impaired in all three groups.
Conclusions: This study did not find evidence for rapid progression of subclinical atherosclerosis and deterioration of dyslipidaemia in HIV patients within 1 year.
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.