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Current Drug Research Reviews

Editor-in-Chief

ISSN (Print): 2589-9775
ISSN (Online): 2589-9783

Systematic Review Article

Dyslipidemia Secondary to the Use of HAART in Adults: A Systematic Review

Author(s): Diogo Pereira Rodrigues Oliveira, Ana Paula Azevêdo Macêdo, Mariane dos Santos Gonçalves and Ricardo David Couto*

Volume 14, Issue 3, 2022

Published on: 22 August, 2022

Page: [239 - 246] Pages: 8

DOI: 10.2174/2589977514666220519165549

Price: $65

Abstract

Background: HIV infection affects millions of people globally. Currently, although several drugs have brought an improvement in the quality and life expectancy of these individuals, they are accompanied by several adverse effects.

Objective: To conduct a systematic review of studies examining the relationship between antiretroviral therapy (ART) uses and secondary dyslipidemia.

Methods: The review followed the criteria defined by PRISMA. Only articles that completely evaluated the lipid profile were included, which consisted of total cholesterol (TC), triglycerides (TG), and LDL cholesterol (LDL-c), HDL cholesterol (HDL-c).

Results: It was observed that the use of nucleoside and non-nucleoside reverse transcriptase inhibitor (NNRTI and NNRTI respectively) drugs and protease inhibitors are the most used in ART and are associated with changes in lipid profiles. The main changes observed were increases in TC, TG, and LDL-c in addition to a decrease in HDL-c. These patients had a higher risk of developing cardiovascular disease not only due to the use of therapy, but also due to the presence of other comorbidities evaluated in these studies, such as obesity, diabetes, and hypertension. The increase in age, the difference between genders, CD4 T-cell count, and viral load, were observed as risk factors for worsening dyslipidemia.

Conclusion: According to the findings of this study, anti-HIV therapy is linked to dyslipidemia, which may or may not be the primary cause, and is frequently connected with a number of metabolic problems that can exacerbate the illness.

Keywords: Human immunodeficiency virus, lipid profile, cardiovascular diseases, antiretroviral therapy, HAART, dyslipidemia.

Graphical Abstract
[1]
Maggi, P.; Di Biagio, A.; Rusconi, S. Cardiovascular risk and dyslipidemia among persons living with HIV: A review. BMC Infect. Dis., 2017, 17(1), 551.
[http://dx.doi.org/10.1186/s12879-017-2626-z]
[2]
Flexner, C. Modern human immunodeficiency virus therapy: Progress and prospects. Clin. Pharmacol. Ther., 2019, 105(1), 61-70.
[http://dx.doi.org/10.1002/cpt.1284] [PMID: 30411787]
[3]
Ji, S.; Xu, Y.; Han, D. Changes in lipid indices in HIV+ Cases on HAART. BioMed Res. Int., 2019, 2019, 2870647.
[http://dx.doi.org/10.1155/2019/2870647] [PMID: 30868068]
[4]
Xavier, H.T.; Izar, M.C.; Faria Neto, J.R. Atualização da diretriz brasileira de dislipidemias e prevenção da aterosclerose–2017. Arq. Bras. Cardiol., 2017, 109(2), 1-76.
[5]
Castro Cabezas, M.; Burggraaf, B.; Klop, B. Dyslipidemias in clinical practice. Clin. Chim. Acta, 2018, 487, 117-125.
[http://dx.doi.org/10.1016/j.cca.2018.09.010] [PMID: 30201369]
[6]
Moher, D.; Liberati, A.; Tetzlaff, J.; Altman, D.G. Reprint--preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Phys. Ther., 2009, 89(9), 873-880.
[http://dx.doi.org/10.1093/ptj/89.9.873] [PMID: 19723669]
[7]
Rivera-Leon, E.A.; Llamas-Covarrubias, I.M.; Soria-Rodriguez, R.A. Serum ghrelin and obestatin levels in HIV-infected patients: Effect of 36 weeks of antiretroviral treatment. Endocrinol. Diabetes Nutr., 2019, 66(1), 4-10.
[http://dx.doi.org/10.1016/j.endien.2019.01.002] [PMID: 30316761]
[8]
Guimarães, M.M.M.; Greco, D.B.; Moreira, A.N. Lipid accumulation product index in HIV-infected patients: A marker of cardiovascular risk. Braz. J. Infect. Dis., 2018, 22(3), 171-176.
[http://dx.doi.org/10.1016/j.bjid.2018.03.006] [PMID: 29684319]
[9]
Funderburg, N.T.; Xu, D.; Playford, M.P. Treatment of HIV infection with a raltegravir-based regimen increases LDL levels, but improves HDL cholesterol efflux capacity. Antivir. Ther., 2017, 22(1), 71-75.
[http://dx.doi.org/10.3851/IMP3091] [PMID: 27740536]
[10]
Spinner, C.D.; Kern, K.E.; Zink, A. Neither boosted elvitegravir nor darunavir with emtricitabine/tenofovir disoproxil fumarate increase insulin resistance in healthy volunteers: Results from the STRIBILD-IR study. Antivir. Ther., 2016, 21(7), 627-631.
[http://dx.doi.org/10.3851/IMP3049] [PMID: 27050630]
[11]
Dave, J.A.; Levitt, N.S.; Ross, I.L.; Lacerda, M.; Maartens, G.; Blom, D. Anti-retroviral therapy increases the prevalence of dyslipidemia in South African HIV-infected patients. PLoS One, 2016, 11(3), e0151911.
[http://dx.doi.org/10.1371/journal.pone.0151911] [PMID: 26986065]
[12]
Nsagha, D.S.; Weledji, E.P.; Assob, N.J.C. Highly active antiretroviral therapy and dyslipidemia in people living with HIV/AIDS in Fako Division, South West Region of Cameroon. BMC Cardiovasc. Disord., 2015, 15(1), 95.
[http://dx.doi.org/10.1186/s12872-015-0090-5] [PMID: 26315756]
[13]
Osoti, A.; Temu, T.M.; Kirui, N. Metabolic syndrome among antiretroviral therapy-naive versus experienced HIV-infected patients without preexisting Cardiometabolic disorders in Western Kenya. AIDS Patient Care STDS, 2018, 32(6), 215-222.
[http://dx.doi.org/10.1089/apc.2018.0052] [PMID: 29851503]
[14]
Gleason, R.L., Jr; Caulk, A.W.; Seifu, D. Current Efavirenz (EFV) or ritonavir-boosted lopinavir (LPV/r) use correlates with elevate markers of atherosclerosis in HIV-infected subjects in Addis Ababa, Ethiopia. PLoS One, 2015, 10(4), e0117125.
[http://dx.doi.org/10.1371/journal.pone.0117125] [PMID: 25915208]
[15]
Belay, E.; Seifu, D.; Amogne, W.; Kibret, K.T. Lipid profile derangements among human immunodeficiency virus infected adults receiving first line anti-retroviral therapy in Tikur Anbesa specialized hospital, Addis Ababa, Ethiopia: Comparative cross-sectional study. J. AIDS Clin. Res., 2014, 5, 328.
[16]
Lo, J.; Rosenberg, E.S.; Fitzgerald, M.L.; Bazner, S.B.; Ihenachor, E.J. High-density lipoprotein-mediated cholesterol efflux capacity is improved by treatment with antiretroviral therapy in acute human immunodeficiency virus infection. Open Forum Infect. Dis., 2014, 1(3), ofu108.
[17]
Kirichenko, T.V.; Myasoedova, V.A.; Shimonova, T.E. Atherosclerosis in subjects newly diagnosed with human immunodeficiency virus infection. Biosci. Rep., 2018, 38(4), BSR20180597.
[http://dx.doi.org/10.1042/BSR20180597] [PMID: 29961673]
[18]
Kazooba, P.; Kasamba, I.; Mayanja, B.N. Cardiometabolic risk among HIV-POSITIVE Ugandan adults: Prevalence, predictors and effect of long-term antiretroviral therapy. Pan Afr. Med. J., 2017, 27(1), 40.
[http://dx.doi.org/10.11604/pamj.2017.27.40.9840] [PMID: 28761616]
[19]
da Cunha, J.; Maselli, L.M.; Stern, A.C.; Spada, C.; Bydlowski, S.P. Impact of antiretroviral therapy on lipid metabolism of human immunodeficien-cy virus-infected patients: Old and new drugs. World J. Virol., 2015, 4(2), 56-77.
[http://dx.doi.org/10.5501/wjv.v4.i2.56] [PMID: 25964872]
[20]
Non, L.R.; Escota, G.V.; Powderly, W.G. HIV and its relationship to insulin resistance and lipid abnormalities. Transl. Res., 2017, 183, 41-56.
[http://dx.doi.org/10.1016/j.trsl.2016.12.007] [PMID: 28068521]
[21]
Willig, A.L.; Overton, E.T. Metabolic complications and glucose metabolism in HIV infection: A review of the evidence. Curr. HIV/AIDS Rep., 2016, 13(5), 289-296.
[http://dx.doi.org/10.1007/s11904-016-0330-z] [PMID: 27541600]
[22]
Nakaranurack, C.; Manosuthi, W. Prevalence of Non-AIDS comorbidities and factors associated with metabolic complications among HIV-infected patients at a thai referral hospital. J. Int. Assoc. Provid. AIDS Care, 2018, 17, 2325957417752256.
[http://dx.doi.org/10.1177/2325957417752256] [PMID: 29357771]
[23]
Wong, C.; Gange, S.J.; Moore, R.D. Multimorbidity among persons living with human immunodeficiency virus in the United States. Clin. Infect. Dis., 2018, 66(8), 1230-1238.
[http://dx.doi.org/10.1093/cid/cix998] [PMID: 29149237]
[24]
Peçanha, EP; Antunes, OA; Tanuri, A Estratégias farmacológicas para a terapia anti-AIDS. Quim Nova, 2002, 25(6/B), 1108-16.
[25]
Matoga, M.M.; Hosseinipour, M.C.; Aga, E. Hyperlipidaemia in HIV-infected patients on lopinavir/ritonavir monotherapy in resource-limited settings. Antivir. Ther., 2017, 22(3), 205-213.
[http://dx.doi.org/10.3851/IMP3101] [PMID: 27740537]
[26]
Lundgren, J.; Mocroft, A.; Ryom, L. Contemporary protease inhibitors and cardiovascular risk. Curr. Opin. Infect. Dis., 2018, 31(1), 8-13.
[http://dx.doi.org/10.1097/QCO.0000000000000425] [PMID: 29232276]
[27]
Squillace, N.; Bozzi, G.; Colella, E.; Gori, A.; Bandera, A. Darunavir-cobicistat-emtricitabine-tenofovir alafenamide: Safety and efficacy of a prote-ase inhibitor in the modern era. Drug Des. Devel. Ther., 2018, 12, 3635-3643.
[http://dx.doi.org/10.2147/DDDT.S147493] [PMID: 30464395]
[28]
Jain, A.; Kolvekar, T.; Nair, D.R. HIV infection and lipids. Curr. Opin. Cardiol., 2018, 33(4), 429-435.
[http://dx.doi.org/10.1097/HCO.0000000000000520] [PMID: 29601329]
[29]
Levy, M.E.; Greenberg, A.E.; Magnus, M.; Younes, N.; Castel, A. Immunosuppression and HIV viremia associated with more atherogenic lipid profile in older people with HIV. AIDS Res. Hum. Retroviruses, 2019, 35(1), 81-91.
[http://dx.doi.org/10.1089/aid.2018.0145] [PMID: 30353737]
[30]
Oliveira, R.V.C.; Shimakura, S.E.; Campos, D.P. Effects of antiretroviral treatment and nadir CD4 count in progression to cardiovascular events and related comorbidities in a HIV Brazilian cohort: A multi-stage approach. AIDS Care, 2018, 30(5), 551-559.
[http://dx.doi.org/10.1080/09540121.2017.1391984] [PMID: 29058481]
[31]
Masiá, M.; Bernal, E.; Robledano, C. Long-term effects of an intensive intervention in HIV-infected patients with moderate-high athero-sclerotic cardiovascular risk. J. Antimicrob. Chemother., 2014, 69(11), 3051-3056.
[http://dx.doi.org/10.1093/jac/dku269] [PMID: 25038306]
[32]
Calza, L.; Colangeli, V.; Manfredi, R.; Bon, I.; Re, M.C.; Viale, P. Clinical management of dyslipidaemia associated with combination antiretroviral therapy in HIV-infected patients. J. Antimicrob. Chemother., 2016, 71(6), 1451-1465.
[http://dx.doi.org/10.1093/jac/dkv494] [PMID: 26846208]
[33]
Chastain, D.B.; Stover, K.R.; Riche, D.M. Evidence-based review of statin use in patients with HIV on antiretroviral therapy. J. Clin. Transl. Endocrinol., 2017, 8, 6-14.
[http://dx.doi.org/10.1016/j.jcte.2017.01.004] [PMID: 29067253]

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