Cardiometabolic risk factors among HIV patients on antiretroviral therapy

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  • Kiage, James N
    • Other Affiliation: Department of Medicine, Division of Epidemiology, Vanderbilt University, Nashville, TN 37203, USA
  • Heimburger, Douglas C
    • Other Affiliation: Department of Medicine, Division of Epidemiology, Institute for Global Health, Vanderbilt University, Nashville, TN 37203, USA; Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294, USA
  • Nyirenda, Christopher K
    • Other Affiliation: Ndola Central Hospital and Copperbelt University School of Medicine, Ndola, Zambia
  • Wellons, Melissa F
    • Other Affiliation: Department of Medicine, Division of Diabetes, Endocrinology and Metabolism, Vanderbilt University, Nashville, TN 37203, USA
  • Bagchi, Shashwatee
    • Other Affiliation: Department of Medicine, University of Maryland, Baltimore, MD 21201, USA
  • Chi, Benjamin
    • Affiliation: School of Medicine, Department of Obstetrics and Gynecology
    • Other Affiliation: Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
  • Koethe, John R
    • Other Affiliation: Department of Medicine, Division of Infectious Diseases, Vanderbilt University, Nashville, TN 37203, USA; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
  • Arnett, Donna K
    • Other Affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
  • Kabagambe, Edmond K
    • Other Affiliation: Department of Medicine, Division of Epidemiology, Vanderbilt University, Nashville, TN 37203, USA; Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
Abstract
  • Abstract: Background: HIV 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. Methods: Adult 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. Results: From 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. Conclusion: Our 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.
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  • Article
Rights statement
  • In Copyright
Rights holder
  • James N Kiage et al.; licensee BioMed Central Ltd.
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Journal title
  • Lipids in Health and Disease
Journal volume
  • 12
Journal issue
  • 1
Page start
  • 50
Language
  • English
Is the article or chapter peer-reviewed?
  • Yes
ISSN
  • 1476-511X
Bibliographic citation
  • Lipids in Health and Disease. 2013 Apr 10;12(1):50
Publisher
  • BioMed Central Ltd
Access right
  • Open Access
Date uploaded
  • June 10, 2016

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