Highly active antiretroviral therapy (HAART) reduces AIDS-related morbidity and mortality, however it has been associated with metabolic abnormalities. This study estimated the prevalence of lipid abnormalities and related factors among patients on HAART. A cross-sectional study was conducted on adult patients, in central Brazil. Patients were interviewed, and blood obtained for lipids measurement. Dyslipidemia was defined as total cholesterol (TC) ≥ 240mg/dL, low-density lipoprotein (LDL) ≥ 160mg/dL, triglycerides (TG)>200 and/or high-density lipoprotein (HDL)<40mg/dL. Multiple logistic regression analyses were performed (SPSS 13.0). One hundred and thirteen patients were recruited. Mean age was 39.3 years; 68.1% were males; 50.4% were on nucleoside reverse transcriptase inhibitors (NRTI) in combination with non-nucleoside reverse transcriptase inhibitors (NNRTI), while 42.5% were on NRTI in combination with protease inhibitors (PIs). The prevalence of dyslipidemia was 66.7%. Low HDL was the most frequent abnormality (53.5%), followed by high TG (36.1%). Patients on a PI regimen had a 5.2-fold higher risk (95% CI: 1.8-14.8) of dyslipidemia, even after adjusting for sex, age, and duration of HIV infection/AIDS. The study discloses a high prevalence rate of dyslipidemia and points out a need for intervention programs to reduce future cardiovascular events in patients, on HAART.
Journal Information
Vol. 15. Issue 2.
Pages 151-155 (March - April 2011)
Vol. 15. Issue 2.
Pages 151-155 (March - April 2011)
Brief Communication
Open Access
Dyslipidemia in AIDS patients on highly active antiretroviral therapy
Visits
2715
Max Weyler Nery1,
, Celina Maria Turchi Martelli2, Marília Dalva Turchi2
Corresponding author
maxwnery@uol.com.br
Correspondence to: Departamento de Medicina da Pontifícia, Universidade Católica de Goiás, Av. Universitária, 1440, Setor Universitário, Área IV, CEP: 74.605-010 Goiânia, Goiás, Brasil Phone: (62) 3250 4000, 3250 4014, Fax: (62) 3250 4024.
Correspondence to: Departamento de Medicina da Pontifícia, Universidade Católica de Goiás, Av. Universitária, 1440, Setor Universitário, Área IV, CEP: 74.605-010 Goiânia, Goiás, Brasil Phone: (62) 3250 4000, 3250 4014, Fax: (62) 3250 4024.
This item has received
Article information
Abstract
Keywords:
prevalence
dyslipidemia
HIV
AIDS
HAART
Full text is only aviable in PDF
References
[1.]
F.J. Palella Jr., K.M. Delaney, A.C. Moorman, et al.
Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators.
N Engl J Med, 338 (1998), pp. 853-860
[2.]
W.T. Enanoria, C. Ng, S.R. Saha, J.M. Colford Jr.
Treatment outcomes after highly active antiretroviral therapy: a meta-analysis of randomised controlled trials.
Lancet Infect Dis, 4 (2004), pp. 414-425
[3.]
A. Carr, D.A. Cooper.
Adverse effects of antiretroviral therapy.
Lancet, 356 (2000), pp. 1423-1430
[4.]
D.A. Wohl, G. McComsey, P. Tebas, et al.
Current concepts in the diagnosis and management of metabolic complications of HIV infection and its therapy.
Clin Infect Dis, 43 (2006), pp. 645-653
[5.]
D.C. Rhew, M. Bernal, D. Aguilar, U. Iloeje, M.B. Goetz.
Association between protease inhibitor use and increased cardiovascular risk in patients infected with human immunodeficiency virus: a systematic review.
Clin Infect Dis, 37 (2003), pp. 959-972
[6.]
M. Saves, G. Chene, P. Ducimetiere, et al.
Risk factors for coronary heart disease in patients treated for human immunodeficiency virus infection compared with the general population.
Clin Infect Dis., 37 (2003), pp. 292-298
[7.]
N. Friis-Moller, P. Reiss, C.A. Sabin, et al.
Class of antiretroviral drugs and the risk of myocardial infarction.
N Engl J Med, 356 (2007), pp. 1723-1735
[8.]
A. Grangeiro, L. Teixeira, F.I. Bastos, P. Teixeira.
Sustainability of Brazilian policy for access to antiretroviral drugs.
Rev Saude Publica, 40 (2006), pp. 60-69
[9.]
I. Dourado, M.A. Veras, D. Barreira, A.M. de Brito.
AIDS epidemic trends after the introduction of antiretroviral therapy in Brazil.
Rev Saude Publica, 40 (2006), pp. 9-17
[10.]
B. Caramelli, C.Y. de Bernoche, A.M. Sartori, et al.
Hyperlipidemia related to the use of HIV-protease inhibitors: natural history and results of treatment with fenofibrate.
Braz J Infect Dis, 5 (2001), pp. 332-338
[11.]
E.M. Albuquerque, E.C. de Faria, H.C. Oliveira, D.O. Magro, L.N. Castilho.
High frequency of Fredricksons phenotypes IV and IIb in Brazilians infected by human immunodeficiency virus.
BMC Infect Dis, 5 (2005), pp. 47
[12.]
P.S. de Araujo, R.A. de Alencar Ximenes, C.F. Lopes, J.Y. Duarte, M.M. da Silva, E.M. Carneiro.
Antiretroviral treatment for HIV infection/AIDS and the risk of developing hyperglycemia and hyperlipidemia.
Rev Inst Med Trop São Paulo, 49 (2007), pp. 73-78
[13.]
SBC.
III Brazilian Guidelines on Dyslipidemias and Guideline of Atherosclerosis Prevention from Atherosclerosis Department of Sociedade Brasileira de Cardiologia.
Arq Bras Cardiol, 77 (2001), pp. 1-48
[14.]
W.P. Castelli, R.D. Abbott, P.M. McNamara.
Summary estimates of cholesterol used to predict coronary heart disease.
Circulation, 67 (1983), pp. 730-734
[15.]
M.P. Dube, J.H. Stein, J.A. Aberg, et al.
Guidelines for the evaluation and management of dyslipidemia in human immunodeficiency virus (HIV)-infected adults receiving antiretroviral therapy: recommendations of the HIV Medical Association of the Infectious Disease Society of America and the Adult AIDS Clinical Trials Group.
Clin Infect Dis, 37 (2003), pp. 613-627
[16.]
P.W. Wilson, R.B. D’Agostino, D. Levy, A.M. Belanger, H. Silbershatz, W.B. Kannel.
Prediction of coronary heart disease using risk factor categories.
Circulation, 97 (1998), pp. 1837-1847
[17.]
E. Fontas, F. van Leth, C.A. Sabin, et al.
Lipid profiles in HIV-infected patients receiving combination antiretroviral therapy: are different antiretroviral drugs associated with different lipid profiles?.
J Infect Dis, 189 (2004), pp. 1056-1074
[18.]
N. Friis-Moller, R. Weber, P. Reiss, et al.
Cardiovascular disease risk factors in HIV patient - association with antiretroviral therapy. Results from the DAD study.
Aids, 17 (2003), pp. 1179-1193
[19.]
G.V. Matthews, G.J. Moyle, S. Mandalia, M. Bower, M. Nelson, B.G. Gazzard.
Absence of association between individual thymidine analogues or nonnucleoside analogues and lipid abnormalities in HIV-1-infected persons on initial therapy.
J Acquir Immune Defic Syndr, 24 (2000), pp. 310-315
Copyright © 2011. Elsevier Editora Ltda.. All rights reserved