Effect of antiretroviral therapy on allele-associated Lp(a) level in women with HIV in the Women's Interagency HIV Study

Enkhmaa Byambaa, Anuurad Erdembileg, Wei Zhang, Chin-Shang Li, Robert Kaplan, Jason Lazar, Dan Merenstein, Roksana Karim, Brad Aouizerat, Mardge Cohen, Kenneth Butler, Savita Pahwa, Igho Ofotokun, Adaora A. Adimora, Elizabeth Golub, Lars Berglund

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4 Scopus citations

Abstract

We previously demonstrated an association between lipoprotein (a) [Lp(a)] levels and atherosclerosis in human immunodeficiency virus (HIV)-seropositive women. The effects of antiretroviral therapy (ART) on Lp(a) levels in relation to apo(a) size polymorphism remain unclear. ART effects on allele-specific apo(a) level (ASL), an Lp(a) level associated with individual apo(a) alleles within each allele-pair, were determined in 126 HIV-seropositive women. ART effects were tested by a mixed-effects model across pre-ART and post-ART first and third visits. Data from 120 HIV-seronegative women were used. The mean age was 38 years; most were African-American (∼70%). Pre-ART ASLs associated with the larger (4.6 mg/dl vs. 8.0 mg/dl, P = 0.024) or smaller (13 mg/dl vs. 19 mg/dl, P = 0.041) apo(a) sizes were lower in the HIV-seropositive versus HIV-seronegative group, as was the prevalence of a high Lp(a) level (P = 0.013). Post-ART ASL and prevalence of high Lp(a) or apo(a) sizes and frequency of small size apo(a) (≤22 kringles) did not differ between the two groups. ART increased Lp(a) level (from 18 to 24 mg/dl, P < 0.0001) and both ASLs (P < 0.001). In conclusion, regardless of genetic control, Lp(a) can be modulated by HIV and its treatment. ART initiation abrogates HIV-induced suppression of Lp(a) levels and ASLs, contributing to promote CVD risk in HIV-seropositive individuals.

Original languageEnglish (US)
Pages (from-to)1967-1976
Number of pages10
JournalJournal of Lipid Research
Volume59
Issue number10
DOIs
StatePublished - Jan 1 2018

Keywords

  • Apolipoprotein (a) sizes
  • Apolipoproteins
  • Biomarkers
  • Clinical studies
  • Drug therapy
  • Human immunodeficiency virus treatment
  • Lipoprotein (a)
  • Lipoproteins
  • Longitudinal design
  • Molecular biology/genetics
  • Prospective cohort

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology
  • Cell Biology

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    Byambaa, E., Erdembileg, A., Zhang, W., Li, C-S., Kaplan, R., Lazar, J., Merenstein, D., Karim, R., Aouizerat, B., Cohen, M., Butler, K., Pahwa, S., Ofotokun, I., Adimora, A. A., Golub, E., & Berglund, L. (2018). Effect of antiretroviral therapy on allele-associated Lp(a) level in women with HIV in the Women's Interagency HIV Study. Journal of Lipid Research, 59(10), 1967-1976. https://doi.org/10.1194/jlr.P084517