Association of immune recovery with hyperlipidaemia and apolipoprotein gene polymorphisms following highly active antiretroviral therapy in a cohort of Chinese HIV patients.

ABSTRACT: OBJECTIVE:To examine the associations between CD4 recovery, dyslipidaemia and apolipoprotein (APO) gene single nucleotide polymorphisms (SNPs) following highly active antiretroviral therapy (HAART). DESIGN:Retrospective observational cohort study. SETTING:A major HIV care clinic in Hong Kong. PARTICIPANTS:197 Chinese treatment-naïve HIV patients. OUTCOME MEASURES:Maximum CD4 count and its rise 2-3?years after HAART initiation and their association with abnormal total cholesterol (TC), triglyceride (TG) and 8 selected APO SNP at multiple time points. RESULTS:Before HAART, abnormal levels of TC, TG, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol were detected in 13%, 26%, 59% and 19% of the recruited patients, respectively. APOA5 -1131T>C and c.553G>T were significantly associated with high pre-HAART TG while APOE 2198C>T was correlated with high TG at baseline and/or a rise 2-3?years following HAART initiation. Poor CD4 achievement, defined as the highest CD4 count <350/?L and a net gain of <100/?L, was associated with a low CD4 count ?200/?L at baseline and a rise of TC beyond 5.17?mmol/L following HAART with or without the use of antilipid agents. Conversely, satisfactory CD4 achievement was associated with APOC3 3238GG genotype. Applying a linear generalised estimating equation, APOA5 -1131T>C was shown to be a predictor of a weaker temporal trend for CD4 response in the presence of a low baseline CD4?200/?L. CONCLUSIONS:Dyslipidaemia plays a predictive role in impacting immunological recovery following HAART, which could be partly explained by the APO gene SNP.

SUBMITTER: Chan DP 

PROVIDER: S-EPMC4838726 | biostudies-other | 2016 Apr

REPOSITORIES: biostudies-other