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Published on: October 12, 2017
Prevalence of dyslipidemia and dysglycaemia in HIV infected patients
E M Manuthu1, M D Joshi, G N Lule
1Department of Clinical Medicine and Therapeutics, College of Health Sciences, University of Nairobi, Nairobi, Kenya.
Insights
Highly active antiretroviral therapy (HAART) is linked to dyslipidemia in HIV patients, with increased cholesterol and triglyceride levels. While HAART impacts lipid profiles, it does not significantly affect dysglycaemia.
Area of Science:
- Infectious Diseases
- Metabolic Disorders
- Cardiovascular Health
Background:
- Highly active antiretroviral therapy (HAART) has improved outcomes for individuals with HIV/AIDS.
- Long-term HAART use is associated with metabolic complications, including dysglycaemia and dyslipidemia.
- These metabolic changes raise concerns about accelerated cardiovascular disease risk in HIV-infected patients.
Purpose of the Study:
- To determine the period prevalence of dyslipidemia and dysglycaemia in HIV-infected patients.
- To investigate the association between HAART use and metabolic abnormalities.
- To assess cardiovascular disease risk factors in this population.
Main Methods:
- A cross-sectional comparative group study was conducted.
- The study involved consecutive HIV-positive adult patients at a tertiary HIV out-patient facility.
- Dyslipidemia and dysglycaemia were defined by specific lipid and glucose level criteria.
Main Results:
- The overall prevalence of dyslipidemia was 63.1% and dysglycaemia was 20.7%.
- Patients on HAART exhibited significantly higher total cholesterol, LDL cholesterol, and triglyceride levels compared to HAART-naive patients.
- Low HDL cholesterol was more prevalent in HAART-naive patients, and HAART showed no significant effect on dysglycaemia prevalence.
Conclusions:
- HIV-infected patients exhibit a high prevalence of dyslipidemia.
- HAART is associated with an atherogenic lipid profile, characterized by elevated total and LDL cholesterol and triglycerides.
- HAART use did not appear to be associated with low HDL cholesterol or significantly impact dysglycaemia.
Background:
Highly active antiretroviral therapy (HAART) has dramatically reduced AIDS morbidity and mortality, however long-term metabolic consequences including dysglycaemia and dyslipidemia have raised concern regarding accelerated cardiovascular disease risk.
Objective:
To determine the period prevalence of dyslipidemia and dysglycaemia in HIV-infected patients.
Design:
Cross-sectional comparative group study.
Setting:
Kenyatta National Hospital, a tertiary HIV dedicated out-patient facility.
Subjects:
Consecutive HIV- positive adult patients.
Main Outcome Measures:
Dyslipidemia: presence of raised total or LDL cholesterol or low HDL cholesterol, or raised triglycerides. Dysglycaemia: presence of impaired fasting glucose or impaired glucose tolerance, or diabetes mellitus.
Results:
Between January and April 2006, out of 342 screened patients, 295 were recruited and 58% were females. One hundred and thirty four (45%) were on HAART, 82% of whom were on stavudine, lamivudine and either nevirapine or efavirenz. Overall prevalence of dyslipidemiawas 63.1% and dysglycaemia was 20.7%. High total cholesterol occurred in 39.2% of HAART and 10.0% HAART naive patients (p<0.0001, OR 5.18, CI 3.11-10.86), whereas high LDL cholesterol occurred in 40.8% and in 11.2% respectively (p<0.0001, OR 5.43, CI 2.973-9.917). HDL levels were low in 14.6% and 51.3% among HAART and HAART naive patients, respectively, (p<0.0001, OR 0.16, CI 0.091-0.29) while high triglycerides occurred in 25.6% and 22.5% respectively (p=0.541 OR 1.184 CI 0.688-2.037). Among patients on HAART compared to HAART naive patients, diabetes was found in 1.5% against 1.2% (p=0.85), impaired fasting in 2.2% against 0.6% (p=0.30) and impaired glucose tolerance in 16.4% against 21.1% (p=0.22), respectively.
Conclusions:
HIV- infected patients demonstrated a high prevalence of dyslipidemia. HAART use was associated with high levels of total, and LDL cholesterol and high triglyceride levels, an established athrogenic lipid profile. However, HAART was not associated with low HDL cholesterol and had no significant effect on dysglycaemia.
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