SERUM-LIPID CONCENTRATION WITH REFERENCE TO THE CLINICAL AND IMMUNOLOGICAL STATUS OF HIV-INFECTED MEN

We investigated the serum concentrations of free fatty acids (FFA), ch olesterol, phopholipids and triglycerides in HIV-positive men (n = 50) from three behaviour groups : heterosexuals (n = 16), drug addicts (n = 18) and homosexuals (n = 16) and a control group of HIV-negative me n (n = 25). The circulating concentrations of lipids were analyzed wit h reference to the clinical status of infection and the absolute CD4 c ell count. According to the clinical progression of HIV infection the patients mere divided into two groups (CDC 1987 criteria) : stages II and III (n = 28) and stage IVC (n = 22). HIV-positive men had higher p olyunsaturated fatty acids (PUFA) (+ 100 %), p < (0.001) only in the I I and III stages, lower cholesterol (- 25 % to - 40 %, p < 0.001) and lower phospholipids (- 25 %, p < 0.001) for the two stages than in the controls. The triglycerides were increased only in stage IVC patients compared to the controls (+ 110 %, p < 0.001). According to their CD4 cell count, the patients were divided into four groups : > 400 (n = 1 1), 400-150 (n = 9), 150-50 (n = 9) and (50 (n = 19). Regardless of th e CD4 count, the PUFA mere significantly higher (+ 50 % to + 125 %) an d cholesterol (- 35 % to 45 %) and phospholipids (- 25 % to -30 %) low er than in the controls in ail HIV-infected men except the patients wi th 400-150 CD4. Only the HIV-positive patients with < 50 CD4 cells had elevated triglycerides (+ 97 %, p < 0.001). There was a significant n egative correlation between the CD4 cell count and the serum triglycer ide concentrations (r = - 0.31, p < 0.03).In conclusion, the most elev ated PUFA occurred in EW-positive patients with > 400 CD4, while hyper triglyceridaemia is prevalent in very advanced stages of infection (wi th < 50 CD4). This suggests that there is a relationship between the c irculating PUFA and triglyceride levels and the progression of infecti on and immune suppression. The disturbances in lipid metabolism must n ow be correlated with the underlying metabolic, hormonal and cytokine changes and their role in the development of significant malnutrition and immune perturbations.