The prevalence of dyslipidemia and its correlation with anti-retroviral therapy among people living with HIV in China: A systematic review and meta-analysis
Abstract
Background
Dyslipidemia, a risk factor of cardiovascular diseases, was a long-term adverse event of anti-retroviral drugs. Efavirenz (EFV) and lopinavir/ritonavir (LPV/r) were recommended and the widely used antiretroviral drugs while the proportion of taking integrase strand transfer inhibitors (INSTI)-based regimens are increasing recently in China. Regarding to the large population of people living with HIV (PLWH) in China and the regional fluctuations in prevalence of dyslipidemia, this meta-analysis aims to evaluate the prevalence of dyslipidemia and its correlation with anti-retroviral therapy (ART) among PLWH in China, especially the impact of LPV/r, EFV and INSTI-based regimens.
Methods
We searched English and Chinese databases using MeSH terms to identify all relevant articles. The study participants were divided into ART-naïve and ART-experienced PLWH. The prevalence of dyslipidemia and mean difference of serum lipids were estimated using random-effects models. Subgroup analysis and univariate meta-regression were conducted to evaluate factors associated with prevalence of dyslipidemia among ART-experienced PLWH.
Results
In this meta-analysis, we found dyslipidemia prevalence of 49.8% and 55.1% among ART-naïve and experienced PLWH in China. Elevated triglycerides(TG) and reduced high-density lipoprotein cholesterol (HDL-C) were the most prevalent dyslipidemia, irrespective of ART experience. Dyslipidemia was more common in PLWH residing in South China, with baseline CD4 cell count over 500 cells/μl or with a BMI ≥ 24 kg/m2. Notably, Traditional Chinese medicine adjuvant therapy was associated with higher prevalence of dyslipidemia. Moreover, INSTI-based regimens were significantly linked to higher prevalence of low HDL-C compared to other regimens.
Conclusions
The routine assessment of lipid profiles should be advised among PLWH before and after the initiation of ART in China, especially in patients on INSTI-based regiments. Moreover, early interventions, including physical activity, dietary adjustments, and optimization of ART regimens, should be considered when the dyslipidemia is diagnosed in PLWH.
Authors
Wenjing Z, Fei O, Shenao Z, Yu H, Gengfeng F, Haitao Y
Year
2025
Topics
- Population(s)
- General HIV+ population
- Prevention, Engagement and Care Cascade
- Engagement and Care Cascade
- Engagement and Care Cascade
- Treatment
- Co-morbidities
- Cardiovascular
- Other
