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

Byambaa Enkhmaa, Erdembileg Anuurad, 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

Research output: Contribution to journalArticlepeer-review


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
Issue number10
StatePublished - 2018


  • 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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