Apolipoprotein A and biological half-life of prostaglandin I2 in HIV-1 infection.

Disturbances in lipid and lipoprotein metabolism being reported for HIV-1 infection are a common sign of severe infections. Apolipoprotein A being the main constituent protein of HDL has been described to function as the prostaglandinI2 (PGI2)-stabilising factor. PGI2 is not only one of the most potent biological antiaggregatory substances but seems to exert cell-protective properties in the central nervous system, too. PGI2 half-life as well as lipid [total-cholesterol (total-c), triglycerides] and (apo)lipoprotein [LDL-c, HDL-c and apolipoprotein (apo) AI] levels were investigated in 14 HIV-1 positive patients (13 males, 1 female, aged from 29 to 57 yrs). Patients exhibited decreased levels of total-c, LDL-c, HDL-c and apo AI, respectively, while elevated triglyceride levels were observed. PGI2 half-life was shortened (median 53, range: 15-161 seconds) in the patients' plasma as compared with normal controls ranging from 9-12 minutes. In patients with neurological manifestation (n = 8) the decrease of PGI2 half-life (median: 34 seconds, range: 15-67 seconds) was significantly more pronounced (p < 0.05) than in patients (n = 6) with the absence of any central nervous manifestation (median: 83.5, range: 29-161 seconds). The dramatic changes in both HDL-c and apolipoprotein AI as seen during HIV-1 infection are likely to impair PGI2-stabilisation thus being associated with the presence of peripheral neuropathy, dementia and haemostatic imbalance.