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, Dec 2014

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.

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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)


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Molla Abebe, Samuel Kinde, Getachew Belay, Atsbeha Gebreegziabxier, Feyissa Challa, Tefera Gebeyehu, Paulos Nigussie, Belete Tegbaru. 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, 2014, pp. 380, Volume 7, Issue 1, DOI: 10.1186/1756-0500-7-380