First-line antiretroviral therapy and dyslipidemia in people living with HIV-1 in Cameroon: a cross-sectional study

AIDS Research and Therapy

Jeanne Ngogang²  François JéromeKaze Folefack³  André Pascal Kengne⁴  Awa Foueudjeu Betyoumin²  Eric Walter Pefura Yone¹ 

[1]Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon

[2]Biochemistry laboratory of Yaounde University Center, Cameroon

[3]Medicine Unit of Yaounde General Hospital, Cameroon

[4]South African Medical Research Council & department of Medicine, University of Cape Town, Francie van Zijl Drive, Parow Valley, 7505 Cape Town, South Africa

关键词: Cameroon;    HIV;    dyslipidemia;    antiretroviral therapy;   

Others  :  789709
DOI  :  10.1186/1742-6405-8-33

 received in 2011-06-05, accepted in 2011-09-26,  发布年份 2011

【 摘 要 】

Background

Data on lipid profile derangements induced by antiretroviral treatment in Africa are scarce. The aim of this study was to determine the prevalence and characteristics of lipid profile derangements associated with first-line highly active antiretroviral therapy (ART) among Cameroonians living with human immunodeficiency virus (HIV) infection.

Methods

This cross-sectional study was conducted between November 2009 and January 2010, and involved 138 HIV patients who had never received ART (ART-naive group) and 138 others treated for at least 12 months with first line triple ART regimens that included nevirapine or efavirenz (ART group). Lipid profile was determined after overnight fast and dyslipidemia diagnosed according to the US National Cholesterol Education Program III criteria. Data comparison used chi-square test, Student t-test and logistic regressions.

Results

The prevalence of total cholesterol ≥ 200 mg/dl was 37.6% and 24.6% respectively in ART group and ART-naive groups (p = 0.019). The equivalents for LDL-cholesterol ≥ 130 mg/dl were 46.4% and 21% (p ≤ 0.001). Proportions of patients with total cholesterol/HDL-cholesterol ratio ≥ 5 was 35.5% in ART group and 18.6% in ART-naive group (p ≤ 0.001). The distribution of HDL-cholesterol and triglycerides was similar between the two groups. In multivariable analysis adjusted for age, sex, body mass index, CD4 count and co-infection with tuberculosis, being on ART was significantly and positively associated with raised total cholesterol, LDL-cholesterol and TC/HDL cholesterol. The adjusted odd ratios (95% confidence interval, p-value) ART-treated vs. ART-naïve was 1.82 (1.06-1.12, p = 0.02) for TC ≥ 200 mg/dl; 2.99 (1.74-5.15), p < 0.0001) for LDL-cholesterol ≥ 130 mg/dl and 1.73 (1.04-2.89, p = 0.03) for TC/HDL-cholesterol ≥ 5.

Conclusions

First-line antiretroviral therapy that includes nonnucleoside reverse transcriptase inhibitors is associated with pro-atherogenic adverse lipid profile in people with HIV-1 infection compared to untreated HIV-infected subjects in Yaounde. Lipid profile and other cardiovascular risk factors should be monitored in patients on such therapy so that any untoward effects of treatments can be optimally managed.

【 授权许可】

   
2011 Yone et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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