Lipid disorders in HIV patients: what about raised HDL-cholesterol?

Abstract

Received: February 08, 2019; Accepted: February 15, 2019; Published: February 18, 2019 The lipid disorders seen in individuals with HIV infection include elevated triglycerides (TG) and total cholesterol (TC), a decrease in high-density lipoprotein cholesterol (HDL-C), and variable effects on low-density lipoprotein (LDL) cholesterol. The exact mechanism is still not clear, and the cause could be multifactorial. The individual contributions of HIV infection, specific antiretroviral agents, host genetics and changes in body composition, all should be considered. However, there has been change in the pattern of dyslipidaemia in HIV patients. This is because most of the newer antiretrovirals have better lipid profile, either they are lipid neutral or causes mild dyslipidaemia. Raised lipids have been observed less often and low HDL-C has been observed less often as well. The Multicentre AIDS Cohort Study (MACS) showed that immediately after HIV infection TC and HDL-C dropped and when treatment is started TC goes back to normal or above normal level and HDL-C comes back to normal or near normal [1]. We wonder whether HDL-C can go above normal or even abnormally high in some patients when they are on treatment for a long time. Raised HDL-C has been observed with nevirapine use but is not known to be associated with an abnormally high level. Abnormally high HDL-C has been noted in HIV patients, but the actual prevalence of abnormally high HDL-C is not reported.