Prevalence and cardiovascular associations of elevated lipoprotein(a) in people living with HIV: A cross-sectional study

BACKGROUND: Lipoprotein(a) [Lp(a)] has emerged as an important cardiovascular risk factor. However, the prevalence and determinants of elevated Lp(a) in people living with HIV (PLHIV) remain insufficiently characterised. Since PLHIV have an increased cardiovascular risk even under effective virological control, our aim was to explore the prevalence of elevated Lp(a) and its association with cardiovascular risk in this population. METHODS: We conducted a single-centre observational study in adult PLHIV with sustained virological suppression and without active oncological or infectious comorbidities. According to most international consensus statements, elevated Lp(a) was defined as levels >50 mg/dL. RESULTS: A total of 186 PLHIV were included. Of these, 21% had Lp(a) levels >50 mg/dL. Individuals with elevated Lp(a) had significantly higher total cholesterol, Low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B levels, as well as a higher odds of a cardiovascular event [odds ratio (OR) 5.3, p = 0.018]. Although the proportion of patients receiving lipid-lowering therapy was significantly higher among those with elevated Lp(a), the percentage achieving LDL-C targets according to cardiovascular risk was significantly lower compared with patients with Lp(a)