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CARDIOVASCULAR DISEASE RISK MARKEDLY ELEVATED IN HIV-INFECTED PATIENTS WITH LIPODYSTROPHY

Reuters 30 Jan. 2001

Westport, CT -- Cardiovascular disease risk factors are significantly increased in HIV-infected patients with lipodystrophy, compared with healthy controls as well as with HIV-infected patients without fat redistribution, according to a report published in the January 1st issue of Clinical Infectious Diseases.

Dr Steven from the Massachusetts General Hospital in Boston and colleagues assessed the metabolic and clinical significance of HIV infection with lipodystrophy by comparing 71 patients with both diseases to 213 healthy matched control subjects from the Framingham Offspring Study. In addition, 30 HIV-infected patients without lipodystrophy were compared separately with 90 matched control subjects.

Waist-to-hip ratios, fasting insulin levels, and diastolic blood pressure were significantly increased in the lipodystrophy group compared with controls, the authors note. In addition, patients with both diseases were also more likely to have impaired glucose tolerance, diabetes, hypertriglyceridemia, and reduced levels of high-density lipoprotein (HDL) cholesterol.

Except for HDL cholesterol level, these cardiovascular disease risk factors were greatly diminished in HIV-infected patients without fat redistribution, comparable with control subjects' levels.

"Insulin resistance, dyslipidemia, truncal adiposity, and increased diastolic blood pressure are known to increase cardiovascular risk in patients who are not infected with HIV and may similarly predispose HIV- infected patients with fat redistribution to accelerated cardiovascular disease," the researchers point out.

They conclude that "HIV-infected patients with evidence of fat redistribution, including those who are protease inhibitor-naive and who have peripheral fat loss, are at high risk for metabolic abnormalities, and their fasting lipid levels and glucose tolerance should be tested." Significant dyslipidemia and diabetes mellitus should be treated, they add.

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