Abstract
BackgroundIn the current two decades, dyslipidemia and increased blood glucose as metabolic abnormalities are the most common health threats with a high incidence among HIV/AIDS patients on antiretroviral (ARV) treatment. Scientific investigations and reports on lipid and glucose disorders among HIV infected communities are inadequate especially in those developing such as Malaysia. This cross-sectional survey was mainly aimed to evaluate the prevalence of metabolic abnormalities and associated risk factors among HIV infected population patients on ARV medication.MethodsIn a single reference health center in Malaysia, 2739 adult HIV positive patients on antiretroviral therapy (ART) were studied cross-sectionally using medical records. Besides demographic variables and associated health disorders, those factors which can change the lipid and glucose levels were collected. Logistic Regression was used to find the potential risk factors (p < 0.05).ResultsMajority of the studied population were male (81.1%) and aged between 30–49 (68.6%). Mean CD4 count was 474.25 (cells/mm3) while undetectable RNA viral load was common among 83.3 (%) of subjects. Among 1,583 patients with the recent blood lipid and glucose tests, increased levels of triglyceride (TG) and total cholesterol (TC) were frequently prevalent in half of the population as 59 (%) and 54.2 (%) while 28.7 (%), 35.1 (%) and 38.2 (%) had declined level of high-density lipoprotein (HDL), raised low-density lipoprotein (LDL) and fasting plasma glucose (FPG) which were less common. Dyslipidemia was common in 82.3 (%) of the subjects. Notably, medication with protease inhibitor (PI) was a potential risk for elevated triglyceride (odds ratio (OR) = 2.309, 95% confidence interval (CI) = 1.605–3.324, P = 0.001), high TC (OR = 1.561, 95% CI = 1.123–2.169, P = 0.008) and low HDL (OR = 1.449, 95% CI = 1.037–2.024, P = 0.029). As lifestyle factor, alcohol consumption results as significant risk factor for raised TG (OR = 2.653, 95% CI = 1.353–5.202, P = 0.004). Also having hepatitis raised risk of high FPG level (OR = 1.630, 95% CI = 1.197-2.220, P = 0.002) in this sample population.ConclusionsDyslipidemia is highly common in Malaysian HIV subjects receiving ARV medication. Lifestyle modification, changing PI and switch to other ARV regimen can help in reduction of these abnormalities. Also suitable strategies and plans are necessary to prevent cardiovascular diseases in future.
Highlights
In the current two decades, dyslipidemia and increased blood glucose as metabolic abnormalities are the most common health threats with a high incidence among Human immunodeficiency virus (HIV)/Acquired immune deficiency syndrome (AIDS) patients on antiretroviral (ARV) treatment
They stressed that protease inhibitor (PI) as the third antiretroviral (ARV) class is responsible for these complications in comparison with other ARV categories such as nucleoside analog reverse transcriptase inhibitors (NRTI) and non-nucleoside analog reverse transcriptase inhibitors (NNRTI) and integrase inhibitors (INI)
Patients included in this study met the following criteria: subjects must have been on antiretroviral medication at least for 6 months and stable Highly Active Antiretroviral therapy (HAART) for at least 4 weeks before study entry, had complete or at least partial lipid and glucose panel performed during this study, equal or more than 20 years of age and hold Malaysian citizenship
Summary
In the current two decades, dyslipidemia and increased blood glucose as metabolic abnormalities are the most common health threats with a high incidence among HIV/AIDS patients on antiretroviral (ARV) treatment. Scientific investigations and reports on lipid and glucose disorders among HIV infected communities are inadequate especially in those developing such as Malaysia. This cross-sectional survey was mainly aimed to evaluate the prevalence of metabolic abnormalities and associated risk factors among HIV infected population patients on ARV medication. In reviews by Carr et al (1998), Carr (2000) and Currier et al (2008) on substantial HIV/AIDS studies they explained other than traditional risk factors and HIV infection itself [21,22,23] They stressed that protease inhibitor (PI) as the third antiretroviral (ARV) class is responsible for these complications in comparison with other ARV categories such as nucleoside analog reverse transcriptase inhibitors (NRTI) and non-nucleoside analog reverse transcriptase inhibitors (NNRTI) and integrase inhibitors (INI)
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