The Association Between the History of Switching Antiretroviral Therapy Regimens and Lipid Profile in People Living with HIV: A Retrospective Study

It remains unclear whether the history of switching antiretroviral therapy (ART) regimens is a stand-alone risk factor for lipid deterioration in people living with HIV (PLWH). This study aims to explore the relationship between ART regimen switching history and lipid profiles in PLWH. This is a retrospective analysis of data from individuals with HIV infection aged 16-82, enrolled at Jinyintan Hospital in Wuhan, China, between January 2018 and June 2022. We investigated the potential link between their history of switching ART regimens and their lipid profiles. Locally weighted scatter plot smoother (LOESS) curves were used to depict the dynamic changes in lipid profiles over time. Linear mixed-effects models were employed to assess the differences in lipid levels between individuals with and without a history of ART switches. Out of 708 patients with HIV who began ART between January 2018 and June 2022, 207 (29%) switched regimens at least once, while 501 (71%) remained on their initial regimen throughout the study. Individuals with a history of switching ART exhibited less favorable lipid profiles as identified by LOESS analysis. Linear mixed-effects models indicate that participants who had not previously altered their ART regimens displayed notably lower levels of total cholesterol to high-density lipoprotein (HDL) ratio, total cholesterol, and triglycerides compared to those with a history of ART regimen changes (total cholesterol to HDL ratio, difference -0.19, 95% CI: -0.34 to -0.04; total cholesterol, difference -0.13, 95% CI: -0.25 to 0.00; triglycerides, difference -0.27, 95% CI: -0.43 to -0.11). In contrast, individuals with a history of ART regimen switching had noticeably lower HDL cholesterol (HDL-C) levels [difference: 0.04; 95% confidence intervals (CI) 0.00 to 0.07]. This means that the history of switching ART regimens may be associated with lipid deterioration in PLWH.