Effects of different antiretroviral treatment regimens on blood lipids in patients with HIV/AIDS
Objective To investigate the effects of different combined antiretroviral therapy(cART)regimens on blood lipid levels in HIV/AIDS patients.Methods For HIV/AIDS patients treated with cART using the B/F/TAF regimen,3TC/DTG regimen,TDF/3TC/LPV/r regimen,and TDF/3TC/EFV regimen for more than 6 months,demographic indicators,cART information,and the results of the most recent lipid test were collected.The effects of different regimens on lipids were analyzed using binary logistic regression.Results The study enrolled 2 312 HIV/AIDS patients with an average age of 43.34±13.60 years,including 234 on the B/F/TAF regimen,188 on the 3TC/DTG regimen,334 on the TDF/3TC/LPV/r regimen,and 1,556 on the TDF/3TC/EFV regimen.The overall rate of dyslipidemia was 64.53％(1 492/2 312),with total cholesterol(TC)abnormalities in 19.42％(449/2 312)and triglyceride(TG)abnormalities in 46.19％(1 068/2 312).The prevalence of abnormal high-density lipoprotein cholesterol(HDL-C)was 25.30％(585/2 312),and low-density lipoprotein cholesterol(LDL-C)abnormalities occurred in 16.00％(370/2 312).After adjusting for factors such as sex,age,weight,glucose,blood pressure,and income,the TDF/3TC/LPV/r regimen significantly increased the risk of TG abnormalities(OR=3.313,95％CI:2.538-4.325).The B/F/TAF(OR=2.181,95％CI:1.247-3.813)and 3TC/DTG(OR=2.533,95％CI:1.353-4.743)regimens increased the risk of HDL-C abnormalities,and the 3TC/DTG regimen also increased the risk of LDL-C abnormalities(OR=2.292,95％CI:1.284-4.091).Conclusions The use of protease inhibitor-containing or integrase inhibitor regimens increases the risk of dyslipidemia in AIDS patients.It is crucial to monitor lipid levels closely and adjust antiretroviral regimens promptly in patients with dyslipidemia to reduce the incidence of hyperlipidemia.
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