Cardiometabolic risk factors among HIV patients on antiretroviral therapy

Lipids Health Dis. 2013 Apr 10;12:50. doi: 10.1186/1476-511X-12-50.

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adenine / analogs & derivatives
  • Adenine / pharmacology
  • Adenine / therapeutic use
  • Adolescent
  • Adult
  • Alkynes
  • Anti-HIV Agents / pharmacology
  • Anti-HIV Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active*
  • Benzoxazines / pharmacology
  • Benzoxazines / therapeutic use
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / prevention & control*
  • Cardiovascular Diseases / virology
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Cyclopropanes
  • Female
  • HIV Infections / blood
  • HIV Infections / drug therapy*
  • HIV Infections / virology
  • HIV*
  • Humans
  • Insulin Resistance*
  • Lamivudine / pharmacology
  • Lamivudine / therapeutic use
  • Male
  • Middle Aged
  • Nevirapine / pharmacology
  • Nevirapine / therapeutic use
  • Organophosphonates / pharmacology
  • Organophosphonates / therapeutic use
  • Risk Factors
  • Stavudine / pharmacology
  • Stavudine / therapeutic use
  • Tenofovir
  • Triglycerides / blood
  • Zambia
  • Zidovudine / pharmacology
  • Zidovudine / therapeutic use

Substances

  • Alkynes
  • Anti-HIV Agents
  • Benzoxazines
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Cyclopropanes
  • Organophosphonates
  • Triglycerides
  • Lamivudine
  • Zidovudine
  • Nevirapine
  • Tenofovir
  • Stavudine
  • Adenine
  • efavirenz