Publication Abstract Display
Type: Published Abstract
Title: Hypertriglyceridemia in ART-treated HIV+ individuals: Potential impact on HIV sensory polyneuropathy.
Authors: Banerjee S, McCutchan JA, Ances B, Way L, Deutsch R, Ellis RJ
Year: 2010
Publication: ANA
Volume: Issue: Pages:
Abstract:HIV infection, aging and combination antiretroviral therapy (CART) are associated with hypertriglyceridemia (hyperTG) and oxidative stress, which may augment risk for sensory neuropathy (SN). We evaluated the prevalence and clinical correlates of SN among HIV+ and HIVresearch volunteers at a single baseline (BL) visit. SN was defined as ≥1 clinical sign on a standardized exam including reduced distal vibratory or sharp sensation, and reduced ankle reflexes. Blood TG levels were measured. Concurrent medications and concomitant SN risk factors were evaluated including age, diabetes mellitus, nadir and current CD4 count, history of alcohol abuse/dependence and prior or current use of HIV protease inhibitors, potentially neurotoxic dideoxynucleoside antiretrovirals, and statins, typically given to lower cholesterol and TG. Of 436 HIV+ subjects averaging 52 years old, most were men (86%), on CART (75%), with good virologic suppression (median plasma HIV RNA 1.7 log10 copies/ml) and immune recovery (median CD4 current/nadir, 458/105 cells/mm3). 27% of HIV+ subjects met criteria for SN and 48% of these reported pain, paresthesias or numbness. HIV+ subjects had higher mean TG levels than HIV- (245±242 mg/dl vs 160±97 mg/dL; p <0.003). Among HIV+ individuals, those with TG levels in the highest tertile showed significantly greater risk of SN (odds ratio [OR] 2.9; 95% confidence interval [CI], 1.7-4.9) compared to those in the lowest tertile (reference). Risk remained elevated after adjusting for medication use and for other factors significantly associated with SN including age, nadir CD4 and diabetes mellitus (adjusted OR 2.9 CI, 1.4-6.1). Conclusions: HIV+ individuals frequently have elevated TG levels. After adjusting for concurrent SN risk factors and medications, SN frequency was highest among HIV+ individuals with TG levels in the top tertile. Clinical implications: Future studies should evaluate whether lowering TG by diet or medical therapy can protect against disabling SN

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