Antiretroviral treatment associated hyperglycemia and dyslipidemia among HIV infected patients at Burayu Health Center, Addis Ababa, Ethiopia: a cross-sectional comparative study
BMC Research Notes
Antiretroviral treatment associated hyperglycemia and dyslipidemia among HIV infected patients at Burayu Health Center, Addis Ababa, Ethiopia: a cross-sectional comparative study
Molla Abebe 0
Samuel Kinde 2
Getachew Belay 1
Atsbeha Gebreegziabxier 1
Feyissa Challa 1
Tefera Gebeyehu 1
Paulos Nigussie 1
Belete Tegbaru 1
0 Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar , Gondar , Ethiopia
1 Ethiopian Health and Nutrition Research Institute , Addis Ababa , Ethiopia
2 Department of Medical Laboratory Sciences, School of Allied Health Sciences, College of Health Sciences, Addis Ababa University , Addis Ababa , Ethiopia
Background: The effects of highly active antiretroviral therapy (HAART) on glucose and lipid metabolism among sub-Saharan Africans, for whom access to antiretroviral therapy is expanding, remain largely unknown. Therefore, the aim of this study was to assess antiretroviral treatment associated hyperglycemia and dyslipidemia among HIV infected patients at Burayu health center, Addis Ababa, Ethiopia. Methods: A cross-sectional comparative study was conducted among HIV infected adults at Burayu Health Center, Addis Ababa, Ethiopia from September, 2011 to May, 2012. Equal number of HAART naïve and HAART initiated patients (n = 126 each) were included in the study. Demographic data were collected using a well-structured questionnaire. Total cholesterol (TC), Triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and glucose were determined. The data were analyzed using SPSS version 20 software. Result: Of 252 study participants, 72.2% were females; mean age was 35.3 years; mean Body Mass Index (BMI) was 21.4 (kg/m2); mean time living with the virus was 20.6 months and 15.5% were TB-HIV co-infected. The prevalence of hyperglycemia, increased LDL-C hypercholesterolemia, hypertriglyceridemia and decreased HDL-C were 7.9%, 23%, 42.1%, 46.8% and 50.8% in HAART and 5.6%, 7.1%, 11.1%, 31% and 73% in non-HAART groups, respectively. First line antiretrovirals were drugs containing 2 nucleoside backbones (from Zidovudine/Stavudine/Lamivudine/Tenofovir) with either Nevirapine or Efavirenz. There was statistically significant increase in serum lipid profile levels among HAART initiated patients than HAART naïve individuals (p =0.01 for TG and <0.001 for others). Conclusion: First-line HAART is associated with potentially atherogenic lipid profile levels in patients with HIV infection compared to untreated patients. This indicates glucose and lipid profile levels need to be monitored regularly in HIV infected patients taking antiretroviral treatment.
HIV/AIDS; Dyslipidemia; Hyperglycemia; Antiretroviral therapy; Ethiopia
Background
Highly active antiretroviral therapy (HAART) is the
mainstay of treatment for those infected with HIV [
1
]. Since its
introduction in 1996, mortality and morbidity rates in
HIVinfected individuals in countries with widespread access to
HAART have plummeted. The main effect of HAART is to
suppress viral replication, allowing the individual’s immune
system to recover and protecting from the development of
AIDS and death [
2
]. In recent years, provision of HAART
to those in need has become an increasingly important and
feasible global priority [
3
]. However, the prospect of
maintaining patients on long term HAART may be restricted by
a heterogeneous collection of unexpected metabolic
abnormalities, including dysregulation of glucose metabolism,
dyslipidemia, and/or lipodystrophy [
4,5
]. Use of HAART
has been linked to hyperglycemia, dyslipidemia and
increased risk of cardiovascular disease (CVD) in
HIVinfected patients in industrialized countries. The effects of
HAART on glucose and lipid metabolism among
subSaharan Africans, for whom access to antiretroviral therapy
is expanding, remain largely unknown [6]. This is specially
a major gap that should be given high emphasis in a county
like Ethiopia where increased use of HAART is higher since
2005. Therefore, the aim of this study was to assess
antiretroviral treatment associated hyperglycemia and
dyslipidemia among HIV infected patients at Burayu health center,
Addis Ababa, Ethiopia.
Methods
Study design, setting and period
A cross-sectional comparative study was conducted at
voluntary counseling and testing (VCT) center of Burayu
Health Center in collaboration with Ethiopian Health and
Nutrition Research Institute (EHNRI) from September,
2011 to May, 2012. Two groups of study participants with
age ≥18 years who were either on HAART for at least six
months (HAART initiated group) and HAART naïve HIV
patients (non-HAART groups) who visited the VCT center
during the study period were included in the study.
First-line HAART regimens used were nucleoside reverse
transcriptase inhibitors (NRTIs) [lamivudine (3TC),
zidovudine (AZT), stavudine (D4T) or Tenofovir (...truncated)