Dyslipidemia in HIV positive patients on first line antiretroviral therapy

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Dyslipidemia in HIV positive patients on first line antiretroviral therapy

Journal Title: MedPulse -International Medical Journal - Year 2017, Vol 4, Issue 1

Abstract

Background: Abnormalities of lipid metabolism are common in human immunodeficiency virus (HIV)-infected patients and tend to be accentuated in those receiving highly active antiretroviral therapy (HAART). However, data on lipid profile of treatmentnaïve. HIV-infected patients in India are limited. So, the study was conducted to describe the pattern of lipid profile among treatmentnaive HIV-I positive patients and changes following HAART initiation in a tertiary care center. Methods: An observational prospective study was conducted on 120 normotensive, non-diabetic and non-obese, treatment-naive HIV-infected patients, out of which 65 were men and 55were women of age more than18 years, after applying appropriate inclusion and exclusion criterias. The study was carried out at ART center, in our tertiary care center for a period of 2 years from Dec 2012 to Nov 2014. HIV-I treatment naïve patients were put on different first line ART regimen according to NACO guidelines. Fasting lipid profiles were analyzed enzymatically. Values of lipid parameter were retrieved at the initiation of HAART then patients were followed after 3 and 6 months of HAART therapy. Results The study concluded that there was significant change in the lipid parameters following initiation of HAART, there was increase in mean TC,TG and LDL-C values at 3 months and further increase at 6 months with statistically highly significant P value(< 0.001). At the end of 6 month compared to baseline there was highly significant change in Triglycerides(139.33±23.82 to 145.77±24.42), TC(147.11±28.36 to 153.77 ± 28.74) and LDL (92.55 ± 11.94 to 98.11 ± 12.94) respectively , P value (< 0.001 ). There was no statistical difference in HDL value at the end of 3 month [p value (0.684)] as compared to baseline value, but at the end of 6 month it significantly changes 41.22 ± 2.38 to 38.55 ± 2.69 p value (< 0.001). Conclusions: With the use of first-line antiretroviral therapy regimens were associated with raised total cholesterol, LDL-cholesterol, and triglycerides, an established atherogenic lipid profiles Therefore we recommend that Lipid profiles should be performed at baseline before commencement of antiretroviral therapy and then periodically through treatment follow-up to monitor any rising trends .Lipid profile results can therefore be a good index for disease progression, intervention and management of HIV patients.

Authors and Affiliations

R N Salame, P L Patil

Keywords

Highly active antiretroviral therapy; Human immunodeficiencyvirus; Low density lipoprotein; Very low density lipoprotein;High density lipoprotein; Triglyceride; Total cholesterol.

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