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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