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Impact of antiretroviral therapy on serum lipoprotein levels and dyslipidemias : a systematic review and meta-analysis
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Nduka, Chidozie U., Sarki, Ahmed M., Uthman, Olalekan A. and Stranges, Saverio (2015) Impact of antiretroviral therapy on serum lipoprotein levels and dyslipidemias : a systematic review and meta-analysis. International Journal of Cardiology, 199 . pp. 307-318. doi:10.1016/j.ijcard.2015.07.052 ISSN 0167-5273.
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Official URL: http://dx.doi.org/10.1016/j.ijcard.2015.07.052
Abstract
Background:
Antiretroviral drugs increase biosynthesis and reduce hepatic clearance of serum cholesterol. It is thus important to evaluate the impact of antiretroviral treatment on serum lipoprotein levels and the risk of dyslipidemia.
Methods:
We searched EMBASE and PubMed for articles comparing lipid profiles between HIV-infected adult patients naïve and exposed to antiretroviral therapy (ART). Eligible studies were pooled by performing random-effects meta-analyses of mean serum lipoprotein levels and prevalence estimates of dyslipidemias.
Results:
51 observational studies comprising 37,110 patients were included in the meta-analyses. ART-exposed patients had significantly higher concentrations of total cholesterol (45 studies, mean difference [MD] = 29.4 mg/dL, 95% confidence interval [CI] 26.5 to 32.4, I2 = 82.2%), low density lipoprotein-cholesterol (37 studies, MD = 14.9 mg/dL, 95% CI 11.2 to 18.5, I2 = 86.1%), and triglycerides (43 studies, MD = 46.8 mg/dL, 95% CI 37.8 to 55.8, I2 = 97.1%), compared to ART-naïve patients. The risks of hypercholesterolemia (25 studies, pooled odds ratio [OR] 3.8, 95% CI 3.1 to 4.7, I2 = 60.0%) and hypertriglyceridemia (21 studies, OR 2.2, 95% CI 1.7 to 2.9, I2 = 81.7%) were also significantly higher among ART-exposed patients, compared to ART-naïve patients.
Conclusion:
Antiretroviral therapy is significantly associated with increase in serum lipid levels and increased risk of dyslipidemia. Whether or not these associations are causal should be investigated by future studies.
Item Type: | Journal Article | ||||||||||
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Subjects: | Q Science > QP Physiology Q Science > QR Microbiology R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine |
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Antiretroviral agents , Highly active antiretroviral therapy, Lipoproteins, Dyslipoproteinemias , HIV infections | ||||||||||
Journal or Publication Title: | International Journal of Cardiology | ||||||||||
Publisher: | Elsevier Ireland Ltd. | ||||||||||
ISSN: | 0167-5273 | ||||||||||
Official Date: | 15 November 2015 | ||||||||||
Dates: |
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Volume: | 199 | ||||||||||
Page Range: | pp. 307-318 | ||||||||||
DOI: | 10.1016/j.ijcard.2015.07.052 | ||||||||||
Status: | Peer Reviewed | ||||||||||
Publication Status: | Published | ||||||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||||||
Funder: | University of Warwick Joint Scholarship, Forskningsrådet för arbetsliv och socialvetenskap (Sweden) (FAS) | ||||||||||
Grant number: | 1160088 |
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