Anti-Retroviral Therapy Increases the Prevalence of Dyslipidemia in South African HIV-Infected Patients

Purpose

Data on the prevalence of dyslipidaemia and associated risk factors in HIV-infected patients from sub-Saharan Africa is sparse. We performed a cross-sectional analysis in a cohort of HIV-infected South African adults.

Methods

We studied HIV-infected patients who were either antiretroviral therapy (ART)-naive or receiving non-nucleoside reverse transcriptase inhibitor (NNRTI)-based or protease inhibitor (PI)-based ART. Evaluation included fasting lipograms, oral glucose tolerance tests and clinical anthropometry. Dyslipidemia was defined using the NCEP ATPIII guidelines.

Results

The median age of the participants was 34 years (range 19–68 years) and 78% were women. The prevalence of dyslipidemia in 406 ART-naive and 551 participants on ART was 90.0% and 85%, respectively. Low HDL-cholesterol (HDLC) was the most common abnormality [290/406 (71%) ART-naïve and 237/551 (43%) ART- participants]. Participants on ART had higher triglycerides (TG), total cholesterol (TC), LDL-cholesterol (LDLC) and HDLC than the ART-naïve group. Severe dyslipidaemia, (LDLC> 4.9 mmol/L or TG >5.0 mmol/L) was present in <5% of participants. In multivariate analyses there were complex associations between age, gender, type and duration of ART and body composition and LDLC, HDLC and TG, which differed between ART-naïve and ART-participants.

Conclusion

Participants on ART had higher TG, TC, LDLC and HDLC than those who were ART-naïve but severe lipid abnormalities requiring evaluation and treatment were uncommon.

Below:  Distribution of lipid abnormalities in treatment naïve (A) and participants receiving ART (B).

The left-sided Venn diagrams indicate % with dyslipidaemia. The right-sided diagrams indicate the individual lipid abnormalities in dyslipidaemic participants. Percentages in the right diagrams refer to % dyslipidaemic participants. Rounding accounts for percentages not equal to 100. 

Full article at:   http://goo.gl/HqvLhU

By:  

Joel A. Dave, Naomi S. Levitt, Ian L. Ross 
Divisions of Diabetic Medicine and Endocrinology, Department of Medicine, University of Cape Town, Cape Town, South Africa

Miguel Lacerda 

Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa

Gary Maartens 

Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa

Dirk Blom 

Division of Lipidology, Department of Medicine, University of Cape Town, Cape Town, South Africa 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health