Alteration in Lipid Profile in Treatment-Naive HIV-Infected Patients and Changes Following HAART Initiation in Haryana

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 treatment-naive HIV-infected patients in India are limited. So, the study was conducted to describe the pattern of lipid profile among treatment-naive HIV-positive patients and changes following HAART initiation in Haryana.

Methods: Data were collected from 100 normotensive, non-diabetic and non-obese, treatment-naive HIV-infected patients (65 men and 35 women, mean age 36.4 years) and 100 healthy controls. The study was carried out at ART center in PGIMS, Rohtak for a period of 1 year. Fasting lipid profiles were analyzed enzymatically. Values of lipid parameter were retrieved after 3 and 6 months on HAART.

Results: The study observed a significant increased level of triglyceride (TG) (178.46 58.41 mg%) and low density lipoprotein cholesterol (LDL-C) (108.62 38.67 mg%) and a significant decreased level of high density lipoprotein cholesterol (HDL-C) (26.86 12.69 mg%) as compared to HIV-negative healthy controls. Total cholesterol (TC) was also low (171.17 52.24 mg%) as compared to controls though this is not significant statistically. Following HAART initiation, there were large increases in mean TC, TG and LDL-C values at 3 months and further increase at 6 months of therapy (12.01, 17.26 and 16.71 mg% respectively) with statistically highly significant P value (< 0.001). HDL levels remained low throughout follow-up. A total of 61% patients showed dyslipidemia following HAART.

Conclusions: HIV-1 replication alone without any influence of antiviral drugs or other human genetic factors induces changes in serum lipid profile parameters which could be used to determine HIV-infected persons with high risk of myocardial infarction before enrollment for HAART. Therefore, fasting plasma lipid profile should be done of all HIV-infected persons before starting HAART with periodic repetitions after enrolling on HAART, since significant increases in plasma TG, TC and LDL-C concentrations have been reported in HIV patients on HAART. Lipid profile results can therefore be a good index for disease progression, intervention and management of HIV patients.




J Endocrinol Metab. 2014;4(1-2):25-31
doi: http://dx.doi.org/10.14740/jem207w