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Ethnic differences in response to HIV medicines

Researchers from the University of Massachusetts and the University of Pennsylvania have shown that race/ethnicity is a predictor of plasma lipids in patients with HIV-1 on HAART (highly active antiretroviral therapy). The researchers, led by Andrea Foulkes and Muredach Reilly, examined the influence of racial/ethnic influences on plasma lipoproteins, and the genetic effects on lipids in patients with HIV-1.

In a cross-sectional analysis of 626 patients participating in several ongoing AIDS Clinical Trial Group studies, Foulkes and colleagues looked at the way that race/ethnicity, genetic variants of lipoproteins apoC-III/apoA-I, and protease inhibitors (a class of drugs used against HIV) affected plasma lipids. Overall, Black patients on HAART had a lipid profile that meant they were likely to be less prone to atheroma than White and Hispanic patients. They also found that in Hispanic, but not in White or Black patients, certain genetic variants of apoC-III were associated with less dyslipidemia in patients exposed to protease inhibitor-containing highly active antiretroviral therapy.

HIV-1 infection has become a chronic, manageable condition for patients who have long-term access to highly active antiretroviral therapy. However, in some patients, highly active antiretroviral therapy causes various metabolic complications, including the development of dyslipidemia. Some protease inhibitors have been associated with elevated levels of cholesterol, triglyceride, and low high-density lipoprotein cholesterol. Protease-based highly active antiretroviral therapy has also been associated with increased risk for cardiovascular disease, which could, it has been suggested, lead to a future epidemic of cardiovascular disease in patients with HIV-1 treated with this regimen long term.

These findings are believed to be the first evidence for race/ethnicityspecific differences in both the occurrence of dyslipidemia on antiretroviral therapy (ART) and the
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Contact: Paul Ocampo
press@plos.org
415-624-1224
Public Library of Science
23-Jan-2006


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