CARDIOVASCULAR DISEASE RISK MARKEDLY ELEVATED IN HIV-INFECTED PATIENTS
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