Background Antiretroviral therapy (ART), especially the ones based on boosted protease inhibitors (PI/r) may induce dyslipidaemia and therefore increase cardiovascular risk (CVR) on HIV-infected patients. Some studies suggest that Tenofovir (TDF) could be a protective factor.
Purpose To describe the CVR score in HIV-infected patients and identify which kind of ART (PI/r or TDF) is more convenient for lipid profile (LP).
Materials and methods Descriptive cross-sectional study on HIV-patients in a 300 bed hospital during July 2011. Overall 10-years probability for cardiovascular events was evaluated by the Framingham risk score. The authors analysed CVR and LP according to gender, body mass index (BMI), ART-naives and ATR based on PI/r or TDF. Patients were classified as having low, moderate, or high CVR (<10%, 10%–20% and <20%, respectively). Statistical analysis was performed with SPSS.
Results The authors enrolled 47 HIV-infected patients. Values were: median age 48.3±9.8 years, 70.2% male, 30.4% current smokers, mean BMI 23.6±3.3 kg/m2, 23.4% ART-naives, 29.8% on PI/r and 61.7% on TDF. The mean 10-years probability for cardiovascular events was 7.1±6.9%. Patient's prevalence with low, moderate and high CVR was 82.2%, 11.1% and 6.7% respectively. CVR was 8.1% in males compared to 4.7% in women. 4.7% in ART-naïve patients compared to 7.8% in ART-treated patients. 5.6% in BMI<25 kg/m2 patients compared to 10.8% in BMI>25 kg/m2 patients. ART based on TDF had lower CVR than the based on PI/r (5.9% vs 7.8%). ART based on TDF presented lower total cholesterol values than patients treated without TDF (183.4 mg/dl vs 203.2 mg/dl). The opposite was observed with PI/r (196.6 mg/dl vs 188.6 mg/dl). HDL was higher in TDF-ART patients (0.53 mg/dl vs 0.48 mg/dl) and lower in IP/r-ART patients (0.44 mg/dl vs 0.54 mg/dl).
Conclusions The results show that our HIV-patients have better CVR compared to the studies reported in the literature. An ART regime change in patients with bad LP should be considered.
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