Cardiometabolic risk factors among HIV patients on antiretroviral therapy

Lipids in Health and Disease

Research

Benjamin H Chi¹  Donna K Arnett²  Melissa F Wellons³  James N Kiage⁴  Edmond K Kabagambe⁵  Douglas C Heimburger⁶  John R Koethe⁷  Shashwatee Bagchi⁸  Christopher K Nyirenda⁹ 

[1] Centre for Infectious Disease Research in Zambia, Lusaka, Zambia;Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, 27599, Chapel Hill, NC, USA;Department of Epidemiology, University of Alabama at Birmingham, 35294, Birmingham, AL, USA;Department of Medicine, Division of Diabetes, Endocrinology and Metabolism, Vanderbilt University, 37203, Nashville, TN, USA;Department of Medicine, Division of Epidemiology, Vanderbilt University, 37203, Nashville, TN, USA;Department of Medicine, Division of Epidemiology, Vanderbilt University, 37203, Nashville, TN, USA;Department of Epidemiology, University of Alabama at Birmingham, 35294, Birmingham, AL, USA;Department of Medicine, Division of Epidemiology, Vanderbilt University, 37203, Nashville, TN, USA;Institute for Global Health, Vanderbilt University, 37203, Nashville, TN, USA;Department of Nutrition Sciences, University of Alabama at Birmingham, 35294, Birmingham, AL, USA;Department of Medicine, Division of Infectious Diseases, Vanderbilt University, 37203, Nashville, TN, USA;Centre for Infectious Disease Research in Zambia, Lusaka, Zambia;Department of Medicine, University of Maryland, 21201, Baltimore, MD, USA;Ndola Central Hospital and Copperbelt University School of Medicine, Ndola, Zambia;

关键词: Lipids;    cART;    Cardiometabolic risk;    Zambia;   

DOI  :  10.1186/1476-511X-12-50

 received in 2013-02-12, accepted in 2013-04-03,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundHIV and combination antiretroviral therapy (cART) may increase cardiovascular disease (CVD) risk. We assessed the early effects of cART on CVD risk markers in a population with presumed low CVD risk.MethodsAdult patients (n=118) in Lusaka, Zambia were recruited at the time of initiation of cART for HIV/AIDS. Cardiometabolic risk factors were measured before and 90 days after starting cART. Participants were grouped according to cART regimens: Zidovudine + Lamivudine + Nevirapine (n=58); Stavudine + Lamivudine + Nevirapine (n=43); and ‘other’ (Zidovudine + Lamivudine + Efavirenz, Stavudine + Lamivudine + Efavirenz, Tenofovir + Emtricitabine + Efavirenz or Tenofovir + Emtricitabine + Nevirapine, n=17). ANOVA was used to test whether changes in cardiometabolic risk markers varied by cART regimen.ResultsFrom baseline to 90 days after initiation of cART, the prevalence of low levels of high-density lipoprotein cholesterol (<1.04 mmol/L for men and <1.30 mmol/L for women) significantly decreased (78.8% vs. 34.8%, P<0.001) while elevated total cholesterol (TC ≥5.18 mmol/L, 5.1% vs. 11.9%, P=0.03) and the homeostasis model assessment of insulin resistance ≥3.0 (1.7% vs. 17.0%, P<0.001) significantly increased. The prevalence of TC:HDL-c ratio ≥5.0 significantly decreased (44.9% vs. 6.8%, P<0.001). These changes in cardiometabolic risk markers were independent of the cART regimen.ConclusionOur results suggest that short-term cART is associated with a cardioprotective lipid profile in Zambia and a tendency towards insulin resistance regardless of the cART regimen.

【 授权许可】

Unknown   
© Kiage et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.