Reduced high density lipoprotein cholesterol (HDLc) rather than elevated low density lipoprotein (LDLc) is the principal dyslipidaemia in HIV-positive subjects on contemporary antiretroviral therapy (ART)

Dyslipidaemia in HIV-positive subjects on contemporary ART remains to be fully characterized, with elevated total cholesterol, LDL-c and low HDL-c expected compared to HIV-negative subjects. We compared fasting lipids (mmol/l) in a cohort of 210 HIV-positive and 264 HIV-negative subjects and assessed between-group differences in (TC), triglycerides, LDLc, HDLc and TC:HDLc ratio in baseline samples using Mann-Whitney and x[sup 2] tests and multivariable linear/logistic regression. Results are median (interquartile range) unless specified. The principal dyslipidaemia associated with HIV is low HDLc rather than high LDLc, with increases in proatherogenic TC:HDLc ratio driven by low HDLc. Further research into the pathogenesis and therapeutic options for low HDLc in those with HIV is warranted.