The prevalence and risk factors for dyslipidaemia in human immunodeficiency virus-infected children on highly active antiretroviral therapy in Kano, Nigeria

Abstract

Prolonged administration of Highly Active Anti Retroviral Therapy (HAART) is associated with metabolic side effects, especially dyslipidaemia, with potential increase in the risk of development of cardiovascular disease as the affected children mature into adulthood. This study determined the prevalence and risk factors for dyslipidaemia among HIV infected children aged 2-15 years. The study was a comparative study conducted on children aged 2- 15 years attending the Paediatric Infectious Disease Clinic of the Aminu Kano Teaching Hospital, Kano. Study subjects that fulfilled the inclusion criteria were recrutited using systematic sampling technique. Serum lipid profile parameters were measured on blood samples from eighty HIV-infected children on HAART and eighty HIV-infected HAART naive children as patients and controls respectively. Data was analysed using the SPSS software for Windows version16.0. P-values of <0.05 were considered as statistically significant. The overall prevalence of dyslipidaemia in HIVinfected children on HAART was 62.5% (95% CI: 51.8% - 73.1%), while 52.5% (95% CI: 41.5% - 63.4%) of the HIV- infected HAART naive children also had dyslipidaemia. The risk factors associated with hypercholesterolaemia were: age at commencement of HAART less than 2 years (P<0.048; Adjusted Odds Ratio,OR, of 0.38, 95% CI:0.13-1.08) and PI- based HAART regimen (P<0.001; OR=0.18, 95% CI: 0.07-0.49), while age group greater than 5 years (P<0.02; OR=2.78 (95% CI:0.76-10.23), duration of HIV diagnosis greater than one year (P<0.02 fisher’s exact) and duration of treatment on HAART for more than one year (P<0.04; OR=2.32, 95% CI:0.14-38.99) were the risk factors associated with hypertriglyceridaemia among the HIV infected children on HAART. However, on multivariate analysis, PI-based HAART regimen was the only independent predictor of hypercholesterolaemia in the HAART treated children (OR=0.18, 95% CI: 0.07-0.49). Duration of diagnosis greater than 1 year was associated with hypercholesterolaemia in HAART naïve HIV-infected children (P=0.05). The most common dyslipidaemia in HIV-infected children on HAART was hypertriglyceridaemia followed by hypercholesterolaemia while low HDL-cholesterol was the commonest lipid abnormality in the HIV-infected HAART naive children.