Metabolic and body composition changes after six months of highly active antiretroviral therapy in northern Indian patients

This study was carried out to evaluate the metabolic and body composition changes among northern Indian patients receiving combination antiretroviral therapy (cART). We prospectively studied 68 adult patients at the All India Institute of Medical Sciences hospital, New Delhi. The CD4 count, blood pressure, anthropometry, metabolic and bioelectrical impedance data were collected prior to initiation of cART and six months later. The participants had a mean age of 35.9 years and 57 (84%) were male. Hypertension developed in 10.3%. The body mass index, waist circumference, total body fat and lean body mass increased significantly. The total cholesterol, high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol, triglyceride and non-HDL-c increased significantly (P < 0.0001). Diabetes mellitus developed in 2.1%; metabolic syndrome in 19.1% (according to International Diabetes Federation criteria) and 25% (National Cholesterol Education Program--Adult Treatment Panel III criteria). Prolonged survival in the cART era may thus predispose these patients to adverse cardiovascular consequences. To the best of our knowledge, this is the first study of metabolic abnormalities in northern Indian HIV/AIDS patients receiving cART. Larger studies across India with long-term follow-up periods are required to confirm these preliminary findings. We also recommend that frequent biochemical monitoring should be performed in such patients.