Background: Fibroblast Growth Factor 21 (FGF21) serum levels are associated with insulin
resistance and metabolic syndrome in HIV patients.
Objective: To quantify FGF21 levels in HIV patients using antiretroviral therapy (ART) and to analyze
a possible association between serum FGF21 levels and lipid profile, levels of proinflammatory
cytokines, and atherogenic risk factors.
Materials and Methods: Twenty patients with HIV infection, who received ART in a scheme consisting
of Tenofovir/Emtricitabine+Lopinavir/Ritonavir, were enrolled in this study. The serum levels
of FGF21, inflammatory parameters (IL-6 and IL-1β), glucose, cholesterol, triglycerides, and insulin
were determined at baseline and after 36 weeks of treatment. The homeostatic model assessment
for insulin resistance (HOMA-IR) and the atherogenic risk factor were also calculated.
Results: After 36 weeks, serum FGF21 levels decreased significantly (p=0.011), whereas IL-6 levels
(r=0.821, p=0.0001) and the CD4+ T cell count (r=0.446, p=0.048), showed a positive correlation
with the decrease in FGF21 levels. There was an increase in total cholesterol (r=-0.483,
p=0.031), LDL (r=-0.496, p=0.026), VLDL (r=-0.320, p=0.045), and the atherogenic index factor
(r=-0.539, p=0.014), these values showed a negative correlation with FGF21 levels.
Conclusion: The decrease of serum FGF21 levels due to ART is associated with the alteration in
lipid profile and an increased risk for cardiovascular diseases. These variations are predictors of inflammatory
status in HIV patients using antiretroviral therapy.