Serum Lipids and Glucose Abnormalities in HIV/AIDS Patients on Antiretroviral Therapies

Salami, AK; Akande, AA; Olokoba, AB

doi:10.4314/wajm.v28i1.48417

Cited by 10 publications

(6 citation statements)

References 13 publications

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“…Although patients on nucleoside reverse transcriptase inhibitors (NRTI) and non-nucleoside reverse transcriptase inhibitors (NNRTI) may develop lipodystrophy, insulin resistance, high TC and LDL-C, only modest elevations in TG have been described [ 33 , 34 ]. The increased prevalence of hypertriglyceridaemia in HIV patients treated with PI versus the NRTI was also demonstrated in a study by Salami et al [ 35 ]. In our study, only 15 HIV treated patients were on PIs because it is second-line medication, administered when the NRTI-based regimen fails [ 36 ].…”

Section: Discussionmentioning

confidence: 53%

Risk factors and assessment for cardiovascular disease among HIV-positive patients attending a Nigerian tertiary hospital

Osegbe¹,

Soriyan²,

Ogbenna³

et al. 2016

Pan Afr Med J

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IntroductionCardiovascular risk factors are prevalent in HIV-positive patients which places them at increased risk for cardiovascular disease (CVD). We aimed to determine the risk factors and risk assessment for CVD in HIV-positive patients with and without antiretroviral therapy.MethodsThis was a cross-sectional study of HIV-positive patients attending the Lagos University Teaching Hospital, Nigeria. Anthropometric and blood pressure measurements were performed; fasting lipid profile, plasma glucose, homocysteine and hsCRP were determined, as well as prevalences and risk assessments. Statistical tests were used to compare the groups and p-value <0.05 was considered to be significant.Results283 subjects were recruited for this study (100 HIV-positive treatment-naive, 100 HIV-positive treated and 83 HIV negative controls). Compared to the controls, mean (sd) values were significantly higher among HIV-treated subjects: waist circumference = 88.7 (10.4), p = 0.035; systolic bp= 124.9 (20.7), p = 0.014; glucose= 5.54 (1.7), p = 0.015; triglyceride= 2.0 (1.2), p < 0.001; homocysteine= 10.9 (8.9-16.2), p = 0.0003; while hsCRP= 2.9 (1.4-11.6), p = 0.002 and HDL-C = 0.9 (0.4), p = < 0.0001 were higher among the HIV-naïve subjects. Likewise, higher prevalences of the risk factors were noted among the HIV-treated subjects except low HDL-C (p < 0.001) and hsCRP (p = 0.03) which were higher in the HIV-naïve group. Risk assessment using ratios showed high risk for CVD especially in the HIV-naïve group. The median range for Framingham risk assessment was 1.0 - 7.5%.ConclusionRisk factors and risk assessment for CVD are increased in HIV-positive patients with and without antiretroviral therapy. Routine evaluation and risk assessment for CVD irrespective of therapy status is necessary to prevent future cardiovascular events.

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Section: Discussionmentioning

confidence: 53%

Risk factors and assessment for cardiovascular disease among HIV-positive patients attending a Nigerian tertiary hospital

Osegbe¹,

Soriyan²,

Ogbenna³

et al. 2016

Pan Afr Med J

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“…Observations in resource-rich countries show that HIV infection is associated with low serum lipid levels depending on degree of immunosuppression and viraemia [ 6 , 7 ]. Several studies in African settings have made similar observations on patients before ART initiation [ 21 – 24 ]. ART has transformed the lives of HIV infected patients but changes in lipid levels are a recognised complication of ART [ 6 , 9 , 25 ].…”

Section: Discussionmentioning

confidence: 69%

Impact of second-line antiretroviral regimens on lipid profiles in an African setting: the DART trial sub-study

et al. 2014

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BackgroundIncreasing numbers of HIV-infected patients in sub-Saharan Africa are exposed to antiretroviral therapy (ART), but there are few data on lipid changes on first-line ART, and even fewer on second-line.MethodsDART was a randomized trial comparing monitoring strategies in Ugandan/Zimbabwean adults initiating first-line ART and switching to second-line at clinical/immunological failure. We evaluated fasting lipid profiles at second-line initiation and ≥48 weeks subsequently in stored samples from Zimbabwean patients switching before 18 September 2006.ResultsOf 91 patients switched to second-line ART, 65(73%) had fasting samples at switch and ≥48 weeks, 14(15%) died or were lost <48 weeks, 10(11%) interrupted ART for >14 days and 2(2%) had no samples available. 56/65(86%) received ZDV/d4T + 3TC + TDF first-line, 6(9%) ZDV/d4T + 3TC + NVP and 3(5%) ZDV + 3TC with TDF and NVP. Initial second-line regimens were LPV/r + NNRTI in 27(41%), LPV/r + NNRTI + ddI in 33(50%) and LPV/r + TDF + ddI/3TC/ZDV in 6(9%). At second-line initiation median (IQR) TC, LDL-C, HDL-C and TG (mmol/L) were 3.3(2.8-4.0), 1.7(1.3-2.2), 0.7(0.6-0.9) and 1.1(0.8-1.9) respectively. Levels were significantly increased 48 weeks later, by mean (SE) +2.0(0.1), +1.1(0.1), +0.5(0.05) and +0.4(0.2) respectively (p < 0.001; TG p = 0.01). 3% at switch vs 25% 48 weeks later had TC >5.2 mmol/L; 3% vs 25% LDL-C >3.4 mmol/L and 91% vs 41% HDL-C <1.1 mmol/L (p < 0.001). Similar proportions had TG >1.8 mmol/L (0 vs 3%) and TC/HDL-C ≥5 (40% vs 33%) (p > 0.15).ConclusionModest lipid elevations were observed in African patients on predominantly LPV/r + NNRTI-based second-line regimens. Routine lipid monitoring during second-line ART regimens may not be warranted in this setting but individual cardiovascular risk assessment should guide practice.

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“…It is reported that PI worsens dyslipidemia. 82 , 83 In Tanzania, low HDL-c was prevalent in 67% and increased triglyceride in 28%. High triglyceride and low HDL levels were associated with low CD4+ counts ( p <0.001).…”

Section: Methodsmentioning

confidence: 99%

Diabetes, metabolic syndrome and dyslipidemia in people living with HIV in Africa: re-emerging challenges not to be forgotten

Husain¹,

Noor²,

Elmadhoun³

et al. 2017

HIV

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BackgroundThe current challenge in managing people living with human immunodeficiency virus (PLWHIV) includes the identification and monitoring for comorbid health risks associated with HIV and its treatment and longer survival. Dyslipidemia, diabetes mellitus and metabolic syndrome are increasingly seen in PLWHIV.ObjectiveIn this narrative review, we aimed to summarize the current knowledge about diabetes, dyslipidemia and metabolic syndrome in PLWHIV in Africa and also to discuss the challenges that patients as well as health authorities in Africa may face.MethodsPubMed and Google scholar published-English literatures concerning earlier mentioned entities regardless of time limit were critically reviewed.ResultsThe prevalence of metabolic disorders in HIV population in Africa was estimated to range from 2.1% to 26.5% for diabetes and 20.2% to 43.5% for pre-diabetes, 13% to 58% for metabolic syndrome and 13% to 70% for dyslipidemia.ConclusionThe management of metabolic disorders and cardiovascular disease risks related to HIV is complex especially in Africa due to healthcare resources, but our experience suggests that metabolic clinic is beneficial to patients and staff and should be an important part of HIV services especially as the older HIV population is increasing. In this context, cardiovascular risk assessment of HIV-infected patients will become an important component of care in developing countries in Africa and strategies are needed to deal with progressive increase in the epidemic of type 2 diabetes, dyslipidemia and metabolic syndrome.

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Serum Lipids and Glucose Abnormalities in HIV/AIDS Patients on Antiretroviral Therapies

Cited by 10 publications

References 13 publications

Risk factors and assessment for cardiovascular disease among HIV-positive patients attending a Nigerian tertiary hospital

Risk factors and assessment for cardiovascular disease among HIV-positive patients attending a Nigerian tertiary hospital

Impact of second-line antiretroviral regimens on lipid profiles in an African setting: the DART trial sub-study

Diabetes, metabolic syndrome and dyslipidemia in people living with HIV in Africa: re-emerging challenges not to be forgotten

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