Dyslipidemia and fasting glucose impairment among HIV patients three years after the first antiretroviral regimen in a Brazilian AIDS outpatient clinic

Brazilian Journal of Infectious Diseases

Miranda, Angelica Espinosa³  Page, Kimberly¹  Ribeiro-Rodrigues, Rodrigo³  Pinto Neto, Lauro Ferreira da Silva²  Neves, Mariza Barros das² 

[1]University of California, San Francisco, USA

[2]Escola de Ciências da Santa Casa de Vitoria, Vitória, Brazil

[3]Universidade Federal do Espírito Santo, Vitória, Brazil

关键词: Dyslipidemia;    Fasting glucose;    AIDS;    ART;    Co-morbidity;   

DOI  :  10.1016/j.bjid.2012.12.006

来源: Contexto

【 摘 要 】

OBJECTIVE: To evaluate the cumulative incidence of dyslipidemia and fasting glucose impairment three years after initiating the first antiretroviral (ART) regimen and the association with the type of ART regimen in an AIDS outpatient clinic in Brazil.
METHODS: Retrospective cohort of HIV-1 infected patients attending an outpatient HIV clinic in Vitoria, Brazil, between January/2010 and May/2011. Data, including blood pressure, dyslipidemia (high total cholesterol and low HDL-C), fasting glucose, and cardiovascular risk by Framingham Risk Score were abstracted from medical records from clinic visits six months prior and three years after starting ART. We assessed independent associated factors for dyslipidemia using multiple logistic regression.
RESULTS: Four hundred and ninety-eight patients on ART were studied. Median age was 45 years (interquartile range (IQR): 37-52), and median time since HIV diagnosis was 7.7 years (IQR: 3.8-10.0). The proportion of patients with dyslipidemia was 22.3% (95% CI: 18.6-25.9%) 36 months after ART initiation. Triglycerides levels >150 mg/dL (55.2% vs. 25.4%, p = 0.021) and high fasting glucose (5.8% vs. 2.3%, p = 0.034) were diagnosed more frequently after ART use when compared to baseline values. Multiple logistic regression analysis has shown dyslipidemia to be associated with lopinavir/r use [OR = 1.74 (95% CI: 1.12-2.86)].
CONCLUSION: These data show high chance of dyslipidemia after initiation of ART. Long-term follow-up will help identify the impact of ART on cardiovascular risk.

【 授权许可】

CC BY-NC-ND