{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T03:41:09Z","timestamp":1779939669509,"version":"3.53.1"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T00:00:00Z","timestamp":1682553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>This article aimed to compare the prevalence of dyslipidemia and determine risk factors associated with lipid levels in a cohort of HIV-infected patients receiving two different antiretroviral therapy (ART) regimens, nucleoside reverse transcriptase inhibitor\/non-nucleoside reverse transcriptase inhibitor (NRTI\/NNRTI) and nucleoside reverse transcriptase inhibitor\/integrase strand transfer inhibitor (NRTI\/INSTI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This longitudinal study analyzed 633 HIV-infected patients with complete blood lipid profile records for at least 1\u2009year at the ART clinic of Zhongnan Hospital of Wuhan University, China, from June 2018 to March 2021. Demographic and clinical data, including age, gender, body weight, height, current\/former\/non-smoker, current drinker, diabetes mellitus, hypertension, were extracted from electronic medical records. Laboratory tests included hematology, total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), Lipoprotein(a) and CD4 cell count. The observation duration of this study was a maximum of 33\u2009months. Data comparisons were performed using the Chi-square test, Student\u2019s <jats:italic>t<\/jats:italic>-test and Mann\u2013Whitney <jats:italic>U<\/jats:italic> test. Generalized linear mixed-effects model (GLMM) and <jats:italic>value of p<\/jats:italic> &amp;lt;\u20090.05 were used to determine factors associated with serum lipid profiles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this study, the effect of the NNRTIs group on the lipid profile over time was mainly an increase in TC and HDL-C, while a decrease in TC\/HDL-C and LDL\/HDL-C. However, the INSTIs group had higher mean TC and lower HDL-C compared to the NNRTIs group, with significantly increased levels of TC, TG, HDL-C, and LDL-C. In the analysis of dyslipidemia rates, there were significant differences in the prevalence of abnormal TG and TC\/HDL-C in HIV-infected patients receiving two different ART regimen groups during different follow-up periods. Dyslipidemia, defined as hypercholesterolemia, hypertriglyceridemia, and low HDL-C, was more prevalent in the INSTIs group, with a higher risk of developing hypertriglyceridemia and a higher TC\/HDL-C ratio compared to the NNRTIs group. GLMM analysis suggested significantly higher TG values in the INSTIs group (estimated 0.36[0.10, 0.63], SE 0.14, <jats:italic>p<\/jats:italic>\u2009=\u20090.008) compared to the NNRTIs group, even after adjusting for other covariates. In addition, GLMM analysis also showed that age, gender, BMI, CD4 count, and ART duration were associated with dyslipidemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In conclusion, treatment with both commonly-used ART regimens can increase the mean values of lipid profiles and the risk of dyslipidemia. The findings indicated that TG values were significantly higher in the INSTIs group than in HIV-infected patients receiving the NNRTIs regimens. Longitudinal TG values are independently associated with the clinical types of ART regimens.<\/jats:p><jats:p><jats:bold>Clinical Trial Number<\/jats:bold>: ChiCTR2200059861.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1161503","type":"journal-article","created":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T12:00:58Z","timestamp":1682596858000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["The effects of ART on the dynamics of lipid profiles in Chinese Han HIV-infected patients: comparison between NRTI\/NNRTI and NRTI\/INSTI"],"prefix":"10.3389","volume":"11","author":[{"given":"Shengnan","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baozhu","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tielong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,4,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"E349","DOI":"10.1016\/S2352-3018(17)30066-8","article-title":"Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies","volume":"4","author":"Trickey","year":"2017","journal-title":"Lancet HIV"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1603","DOI":"10.1016\/S0140-6736(08)60693-5","article-title":"Population-level effect of HIV on adult mortality and early evidence of reversal after introduction of antiretroviral therapy in Malawi","volume":"371","author":"Jahn","year":"2008","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"2423","DOI":"10.1097\/QAD.0000000000002374","article-title":"Decreased HIV-associated mortality rates during scale-up of antiretroviral therapy, 2011-2016","volume":"33","author":"Otieno","year":"2019","journal-title":"AIDS (London, England)"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"3538","DOI":"10.1093\/eurheartj\/eht388","article-title":"HIV and the heart: the impact of antiretroviral therapy: a global perspective","volume":"34","author":"Thienemann","year":"2013","journal-title":"Eur Heart J"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.trsl.2016.12.007","article-title":"HIV and its relationship to insulin resistance and lipid abnormalities","volume":"183","author":"Non","year":"2017","journal-title":"Transl Res"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1100","DOI":"10.1161\/CIRCULATIONAHA.117.033369","article-title":"Global burden of atherosclerotic cardiovascular disease in people living with HIV","volume":"138","author":"Shah","year":"2018","journal-title":"Circulation"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/j.cjca.2018.11.005","article-title":"Lipid abnormalities in persons living with HIV infection","volume":"35","author":"Waters","year":"2019","journal-title":"Can J Cardiol"},{"key":"ref8","year":""},{"key":"ref9","doi-asserted-by":"publisher","first-page":"2978","DOI":"10.1001\/jama.289.22.2978","article-title":"Impact of HIV infection and HAART on serum lipids in men","volume":"289","author":"Riddler","year":"2003","journal-title":"JAMA"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e0186638","DOI":"10.1371\/journal.pone.0186638","article-title":"Projections of non-communicable disease and health care costs among HIV-positive persons in Italy and the U.S.A.: a modelling study","volume":"12","author":"Smit","year":"2017","journal-title":"PLoS One"},{"key":"ref11","year":"2022"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"2486","DOI":"10.1001\/jama.285.19.2486","article-title":"Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III)","volume":"285","year":"2001","journal-title":"JAMA"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.jacc.2017.11.014","article-title":"NHLBI working group recommendations to reduce lipoprotein(a)-mediated risk of cardiovascular disease and aortic stenosis","volume":"71","author":"Tsimikas","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"74","DOI":"10.5334\/gh.850","article-title":"Lipoprotein(a) and high sensitivity C-reactive protein among patients with HIV in Ghana: the study on cardiovascular risk profile of HIV-infected patients on HAART (SCRIPT)","volume":"15","author":"Appiah","year":"2020","journal-title":"Glob Heart"},{"key":"ref15","first-page":"1179","article-title":"Cardiovascular disease risk factors in HIV patients\u2013association with antiretroviral therapy. Results from the DAD study","volume-title":"AIDS (London, England)","author":"Friis-Moller","year":"2003"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"384","DOI":"10.24875\/GMM.M21000579","article-title":"Lipid profile levels in HIV-AIDS patients on treatment with efavirenz and atazanavir","volume":"157","author":"Geldres-Molina","year":"2021","journal-title":"Cohort Study Gac Med Mex"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1754","DOI":"10.1093\/ije\/dyt198","article-title":"Association of HIV and ART with cardiometabolic traits in sub-Saharan Africa: a systematic review and meta-analysis","volume":"42","author":"Dillon","year":"2013","journal-title":"Int J Epidemiol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/j.ijcard.2015.07.0520","article-title":"Impact of antiretroviral therapy on serum lipoprotein levels and dyslipidemias: a systematic review and meta-analysis","volume":"199","author":"Nduka","year":"2015","journal-title":"Int J Cardiol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1363","DOI":"10.1093\/jac\/dky566","article-title":"Durability of first-line regimens including integrase strand transfer inhibitors (INSTIs): data from a real-life setting","volume":"74","author":"d\u2019Arminio Monforte","year":"2019","journal-title":"J Antimicrob Chemother"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2531","DOI":"10.1056\/NEJMoa2108793","article-title":"Dolutegravir as first- or second-line treatment for HIV-1 infection in children","volume":"385","author":"Turkova","year":"2021","journal-title":"N Engl J Med"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"H1221","DOI":"10.1152\/ajpheart.00445.2020","article-title":"HIV-related cardiovascular disease: any role for high-density lipoproteins?","volume":"319","author":"Hudson","year":"2020","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"84","DOI":"10.7326\/0003-4819-150-2-200901200-00006","article-title":"High-density lipoprotein particle size and concentration and coronary risk","volume":"150","author":"El Harchaoui","year":"2009","journal-title":"Ann Intern Med"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"e25507","DOI":"10.1002\/jia2.25507","article-title":"Cost-effectiveness analysis of integrating screening and treatment of selected non-communicable diseases into HIV\/AIDS treatment in Uganda","volume":"23","author":"Sando","year":"2020","journal-title":"J Int AIDS Soc"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"217","DOI":"10.2147\/HIV.S296170","article-title":"Serum lipid profiles of patients taking Efavirenz-based antiretroviral regimen compared to ritonavir-boosted Atazanavir with an optimized background at Zewditu Memorial Hospital, Addis Ababa, Ethiopia","volume":"13","author":"Muche Belete","year":"2021","journal-title":"HIV"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"e0250328","DOI":"10.1371\/journal.pone.0250328","article-title":"Prevalence of dyslipidaemia among HIV-infected patients receiving combination antiretroviral therapy in north Shewa, Ethiopia","volume":"16","author":"Fiseha","year":"2021","journal-title":"PLoS One"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1161\/CIRCULATIONAHA.111.045120","article-title":"Associations between lipoprotein(a) levels and cardiovascular outcomes in black and White subjects","volume":"125","author":"Virani","year":"2012","journal-title":"Circulation"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1186\/1471-2458-14-236","article-title":"The lipid profile of HIV-infected patients receiving antiretroviral therapy in a rural Cameroonian population","volume":"14","author":"Bekolo","year":"2014","journal-title":"BMC Public Health"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"124","DOI":"10.4103\/2141-9248.105658","article-title":"Can metabolic factors be used Prognostically for short-term mortality in HIV-infected patients?","volume":"2","author":"Jain","year":"2012","journal-title":"Ann Med Health Sci Res"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"e0210629","DOI":"10.1371\/journal.pone.0210629","article-title":"Effect of cardio-metabolic risk factors on all-cause mortality among HIV patients on antiretroviral therapy in Malawi: a prospective cohort study","volume":"14","author":"Amberbir","year":"2019","journal-title":"PLoS One"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1177\/2325957415614642","article-title":"Lipid profile in HIV-infected patients using first-line antiretroviral drugs","volume":"15","author":"Ombeni","year":"2016","journal-title":"J Int Assoc Provid AIDS Care"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"2808","DOI":"10.1097\/CM9.0000000000001245","article-title":"Evolution of blood lipids and risk factors of dyslipidemia among people living with human immunodeficiency virus who had received first-line antiretroviral regimens for 3 years in Shenzhen","volume":"133","author":"Sun","year":"2020","journal-title":"Chin Med J"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"49","DOI":"10.2174\/1874192401105010049","article-title":"HIV and HAART-associated dyslipidemia","volume":"5","author":"Feeney","year":"2011","journal-title":"Open Cardiovasc Med J"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1007\/s11904-019-00442-9","article-title":"Lipidome abnormalities and cardiovascular disease risk in HIV infection","volume":"16","author":"Bowman","year":"2019","journal-title":"Curr HIV\/AIDS Rep"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1080\/14787210.2020.1757430","article-title":"Cardiovascular disease in HIV patients: recent advances in predicting and managing risk","volume":"18","author":"McGettrick","year":"2020","journal-title":"Expert Rev Anti-Infect Ther"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1111\/hiv.12831","article-title":"Cardiovascular disease risk and its determinants in people living with HIV across different settings in South Africa","volume":"21","author":"Roozen","year":"2020","journal-title":"HIV Med"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1111\/hiv.12687","article-title":"Cardiovascular disease\u2010related mortality and factors associated with cardiovascular events in theTREATAsiaHIVObservational database (TAHOD)","volume":"20","author":"Bijker","year":"2019","journal-title":"HIV Med"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.jns.2018.12.026","article-title":"Burden of subclinical carotid atherosclerosis and vascular risk factors among people living with HIV in Ghana","volume":"397","author":"Sarfo","year":"2019","journal-title":"J Neurol Sci"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1161503\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T12:01:05Z","timestamp":1682596865000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1161503\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,27]]},"references-count":37,"alternative-id":["10.3389\/fpubh.2023.1161503"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2023.1161503","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,27]]},"article-number":"1161503"}}