HIV-positive patients treated with HAART who are also coinfected with hepatitis C virus (HCV) are less likely to have abnormally high levels of cholesterol or triglycerides according to a small Spanish study published as a research letter in the April 2003 edition of AIDS.
Investigators looked for the prevalence of hyperlipidemia and its risk factors amongst 197 HIV-positive men attending an outpatient clinic in Vizcaya, Spain. Patients had an average age of 36.8 years, most had injecting drug use as their risk factor for HIV and all were clinically stable.
Blood samples were obtained after an overnight fast. Hyperlipidemia was defined as total cholesterol or triglyceride levels greater than 200mg/dl.
In total, 29.9% of patients were found to have hyperlipidemia. Patients who had been receiving HAART for longer (average 26.7 months versus 24.4 months) were found to have a higher risk of abnormal lipid levels. Changes in body fat distribution were found more often in patients with high blood lipids (38.8%) compared to those with normal lipids (27.7%).
When investigators looked at the anti-HIV drugs which their patients had been treated with, they found that “patients treated with efavirenz had higher rates of hyperlipidemia than patients treated with nevirapine (49% versus 20.7%, respectively), and than those treated with PI (31.5%).”
However, the most interesting finding of the study was “the appreciably lower rate of hyperlipidemia” seen in HIV/HCV coinfected patients. The difference could not be attributed to viral load as the proportion of HIV/HCV and HIV monoinfected patients with undetectable viral load was almost identical (66% versus 67%). Rather, the investigators attributed the difference to “HCV-induced hepatic dysfunction.”
The protective effect of HCV infection on lipids was only seen when a patient was treated with HAART, leading the investigators to theorise that “the interactions of HAART on lipidic metabolism seem to be neutralized by the HCV infection.” However, higher rates of body fat redistribution were found in patients coinfected with HIV/HCV (27% versus 11.8%).
Further information on this website
Hepatitis C - Overview
Body fat changes on HAART (lipodystrophy)
ReferenceCollazos J et al. Hyperlipidemia in HIV-infected patients: the protective effect of hepatitis C virus co-infection. AIDS 17: 927 - 929, 2003.