HYPOCHOLESTEROLEMIA IS ASSOCIATED WITH IMMUNE DYSFUNCTION IN EARLY HUMAN IMMUNODEFICIENCY VIRUS-1 INFECTION

PURPOSE: Patients with the acquired immunodeficiency syndrome exhibit marked disturbances in lipid metabolism. Because altered lipid metabol ism may affect immune processes, this study characterized the lipid pr ofile of asymptomatic individuals infected with the human immunodefici ency virus (HIV-1), in relationship to immune function. PATIENTS AND M ETHODS: Serum levels of triglycerides and cholesterol were determined in 94 asymptomatic HIV-1-infected (Centers for Disease Control stage I I, III) homosexual men and 42 healthy seronegative control subjects. I mmune assessment included measurements of lymphocyte subpopulations (C D4), immune activation (beta2-microglobulin), natural killer cell func tion, and lymphocyte proliferation in response to mitogens phytohemagg lutinin and pokeweed. Dietary intake was determined using a semiquanti tative food frequency questionnaire. RESULTS: Despite greater consumpt ion of saturated fat and cholesterol, significantly lower levels of to tal, high-density, and low-density lipoprotein cholesterol were observ ed in HIV-1-seropositive men, relative to seronegative controls (p <0. 05), with 40% of the HIV-1-infected group demonstrating hypocholestero lemia (less than 150 mg/dL). Low values of total, high-density, and lo w-density cholesterol were associated with elevated levels of beta2-mi croglobulin in HIV-1-seropositive men. No difference between the group s was noted for serum triglycerides. HIV-1-infected subjects did not d emonstrate the significant inverse relationship between cholesterol an d mitogen response observed in seronegative controls. CONCLUSIONS: The se findings indicate that low levels of cholesterol are prevalent duri ng the early stages of HIV-1 infection and associated with specific al terations in immune function, suggesting that hypocholesterolemia may be a useful marker of disease progression.