Race/ethnicity predict lipids, heart-disease risk in HIV-1 patients on protease inhibitors

Researchers at the University of Pennsylvania School of Medicine, in collaboration with the University of Massachusetts, have found that small changes in a human gene, apolipoprotein CIII (apoC-III), which vary in frequency among people of different ethnicity, may help predict which HIV-1 infected patients are likely to develop lipid disorders and be at increased risk for heart disease if they take a particular class of anti-AIDS medicines known as protease inhibitors.

The study, published in the January issue of PloS, Medicine, focuses on the abnormally high levels of triglycerides and low levels of HDL, the "good" cholesterol, found in the blood of HIV-1 infected patients on protease inhibitors as part of combination antiretroviral therapy. These blood fats, known as lipids, put people in the general population at risk for heart attack and stroke. In their study of 626 patients with HIV-1 on antiretroviral therapy, the researchers found that the lipid abnormalities stemming from protease inhibitors varied by race/ethnicity and were associated with variant forms of apoC-III.

The researchers cautioned that much larger, controlled studies would be needed before findings from this initial study could be used by physicians to help tailor antiretroviral regimens to individuals' genetic profiles. They also emphasized that genetics is likely just one factor involved in the race-related differences seen in the lipid levels. Diet, exercise, and other environmental factors, they noted, probably play a role as well.

Still, the study underscores the importance of examining the side effects of antiretroviral drugs across all racial groups, not just among Whites. Scientists said the need for testing the medicines among diverse populations was particularly important as the drugs begin to roll out in developing countries in Asia and Africa, home to more than 95 percent of the estimated 25 million people around the world who are living with HIV-1 infecti

Contact: Karen Kreeger
University of Pennsylvania School of Medicine

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