Key result
HAART is linked to a ~20 mg/dl increase in median Lp(a) levels at 6 months.
Why the study?
Lipoprotein(a) is an emerging cardiovascular risk factor with limited study in Sub-Saharan Africans and unclear interaction with antiretroviral therapy.
Does highly active anti-retroviral therapy (HAART) increase serum lipoprotein(a) and lipid levels in HIV-positive patients?
Cohort (n=168)
No
Does highly active anti-retroviral therapy (HAART) increase serum lipoprotein(a) and lipid levels in HIV-positive patients?
HAART initiation in HIV-positive patients is associated with a significant early increase in serum Lipoprotein(a) and atherogenic lipid profiles, highlighting a potential mechanism for increased cardiovascular risk in this population.
HAART was associated with rising Lp(a) in HIV; hypothesis-generating for CV risk monitoring before practice change.
BACKGROUND: Lipoprotein(a) is an emerging biochemical risk factor for cardiovascular disease that has not been widely studied in people of Sub-Saharan African origin. It’s interaction with antiretroviral agents have been less studied than those of traditional lipid parameters. This study therefore assessed the effect of highly active anti-retroviral therapy (HAART) on lipoprotein(a) levels in HIV-positive patients. METHOD: This was a prospective study of HIV-infected patients on HAART at the HIV Outpatient Clinic of the Lagos University Teaching Hospital. Baseline serum Lp(a)and fasting lipid profiles were determined on sero-positive patients. For sero-positive patients who had immunological indication for HAART, fasting samples were obtained every 2 months for 6 months post commencement of HAART for serum Lp(a) and lipid profile estimation. RESULTS: The median baseline serum level of Lp(a) in HIV-positive patients with CD4 count ≤ 350 was not significantly different from that of HIV-positive patients with CD4 counts ˃350. Median Lp(a) and mean values of TC, TG and LDL-C were all significantly raised at the end of the study (p<0.001). During the study period significant increase in median Lp(a), mean TC, TG and LDL-C were first noticed by the second month. Lp(a) consistently and significantly correlated positively with LDL-C across the two study groups. A significant association was found between Lp(a) levels and duration of HAART, however no significant association was found between Lp(a) levels and type of HAART regimen.><) CONCLUSION: HAART is associated with significant increase in Lp(a). This may have clinical implications as high serum level of Lp(a) is a potential risk factor for myocardial infarction and stroke. Therefore routine monitoring of serum Lp(a) levels especially from the second month of ART may be beneficial for HIV-infected patients in order to reduce the risk of cardiovascular incidence.
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Adizua et al. (2026) conducted a cohort in HIV infection (n=168). Highly Active Anti-Retroviral Therapy (HAART) vs. Baseline was evaluated on Median serum lipoprotein(a) level (mg/dl) (p=<0.001). Highly active anti-retroviral therapy (HAART) significantly increased median serum lipoprotein(a) levels from 29.77 mg/dl at baseline to 49.97 mg/dl after 6 months of treatment (p<0.001).
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