This Article Full Text Full Text (PDF) All Versions of this Article: 25/2/399    most recent 01.ATV.0000152233.80082.9cv1 Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Stein, J. H. Articles by Sosman, J. M. Search for Related Content PubMed PubMed Citation Articles by Stein, J. H. Articles by Sosman, J. M.

(Arteriosclerosis, Thrombosis, and Vascular Biology. 2005;25:399.)
© 2005 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Postprandial Lipoprotein Changes in Patients Taking Antiretroviral Therapy for HIV Infection

James H. Stein; Michelle A. Merwood; Jennifer B. Bellehumeur; Patrick E. McBride; Donald A. Wiebe; James M. Sosman

From the University of Wisconsin Medical School, Madison.

Correspondence to James H. Stein, MD, University of Wisconsin Medical School, 600 Highland Ave, G7/341 CSC (MC 3248) Madison, WI 53792. E-mail jhs{at}medicine.wisc.edu

Objective— Dyslipidemia is common among patients receiving antiretroviral therapy for HIV infection. The purpose of this study was to determine whether postprandial lipemia contributes to the dyslipidemia observed in HIV-positive patients taking antiretroviral therapy.

Methods and Results— A standardized fat load was administered to 65 subjects (group 1 35 HIV-positive subjects receiving protease inhibitors [PIs]; group 2 20 HIV-positive subjects not receiving PIs; group 3 10 HIV-negative controls). Serum triglycerides, retinyl palmitate, and lipoproteins were measured using enzymatic and nuclear magnetic resonance spectroscopic techniques. Compared with HIV-negative controls, peak postprandial retinyl palmitate and large very low-density lipoprotein (VLDL) levels occurred later in both HIV-positive groups, and a delayed decrease in serum triglycerides was observed. However, postprandial areas under the curve (AUCs) for triglycerides, retinyl palmitate, chylomicrons, and large VLDL were similar. Postprandial AUCs for intermediate-density lipoproteins (IDLs) and low-density lipoproteins (LDLs) were higher in group 1 than groups 2 and 3 (all P<0.035).

Conclusions— Postprandial clearance of triglyceride-rich lipoproteins is delayed in HIV-positive individuals receiving antiretroviral therapy. Compared with HIV-positive individuals not on PIs, those taking PIs do not have increased postprandial triglyceride-rich lipoproteins but do have increased postprandial IDLs and LDLs.

An oral fat load was administered to 55 HIV-positive and 10 HIV-negative individuals. Postprandial clearance of triglyceride-rich lipoproteins was delayed in HIV-positive individuals. Compared with HIV-positive subjects not on PIs, those taking PIs do not have increased postprandial triglyceride-rich lipoproteins but do have increased postprandial intermediate-density and low-density lipoproteins.

Key Words: human immunodeficiency virus • lipids • lipoproteins • metabolism • protease inhibitors

This article has been cited by other articles:

				J. Shen, D. K. Arnett, P. Perez-Martinez, L. D. Parnell, C.-Q. Lai, J. M. Peacock, J. E. Hixson, M. Y. Tsai, R. J. Straka, P. N. Hopkins, et al. The effect of IL6-174C/G polymorphism on postprandial triglyceride metabolism in the GOLDN study,boxs J. Lipid Res., August 1, 2008; 49(8): 1839 - 1845. [Abstract] [Full Text] [PDF]

				A. A. Spector HIV Protease Inhibitors and Hyperlipidemia: A Fatty Acid Connection Arterioscler. Thromb. Vasc. Biol., January 1, 2006; 26(1): 7 - 9. [Full Text] [PDF]

				M. A.M. den Boer, J. F.P. Berbee, P. Reiss, M. van der Valk, P. J. Voshol, F. Kuipers, L. M. Havekes, P. C.N. Rensen, and J. A. Romijn Ritonavir Impairs Lipoprotein Lipase-Mediated Lipolysis and Decreases Uptake of Fatty Acids in Adipose Tissue Arterioscler. Thromb. Vasc. Biol., January 1, 2006; 26(1): 124 - 129. [Abstract] [Full Text] [PDF]