Perfil lipídico en pacientes VIH (+) no tratados. Infección VIH: ¿factor de riesgo cardiovascular?

Introduction: Some cases of HIV (+) patients with unexplained vascular disease have been reported and many studies are being performed to determine whether HIV infected individuals have an increased cardiovascular risk (CVR). We propose: to describe lipid profile of untreated HIV (+) patients and to compare it with the HIV (-) and to assess whether any of the lipid abnormalities influence in CVR estimation. Material and Methods: 407 homosexual males: 251 untreated HIV (+), and 156 HIV (-). Biochemistry parameters: Total Cholesterol (CHOL), HDL-Cholesterol (HDL), VLDL-Cholesterol, LDL-Cholesterol (LDL), Triglycerides (TG), Apolipoproteins Al and B (ApoA , y ApoB) and Lipoprotein a. Atherogenic rates: CHOL/HDL, LDL/HDL and log (TG/HDL). HIV (+) patients were classified into three groups according to CD4 lymphocytes number. Results: HIV (+) patients had lower CHOL, HDL, and ApoAl and higher CVR rates. These differences showed also between each HIV (+) group according to CD4 number and control group HIV (-). 76% of the HIV (+) patients showed low levels of HDL (less than 40 mg/dL) as compared with 31% of HIV (-) subjects. Conclusion: Untreated HIV(+) patients lipid profile is different from the HIV (-) subjects one. There are decreases in HDL and Apo A1 from the beginning of the infection that persist along all the CD4 levels. HDL decrease in HIV infection multiplies global CVR in HIV infected individuals, independently of other risk factors.