Comparison of Prevalence of Dyslipidemia and Carotid Atherosclerosis among Newly Diagnosed HIV Reactive Patients and Those on ART

Abstract

Background: Since the availability of highly potent anti-retro viral drugs, the management of the human immunodeficiency virus infection has significantly improved and has increased the patient's survival rate. This increased longevity has unmasked many complications like dyslipidaemias which place them at higher risk of developing atherosclerotic vascular disease. The present study was conducted to compare the prevalence of Dyslipidaemia and Carotid Atherosclerosis among newly diagnosed HIV Reactive patients and Those on ART for 6 months. Methods: This descriptive-cross sectional study was conducted among 200 subjects who attended Medicine OPD, ART Centre and admitted in various medical Wards of Rajindra Hospital, Patiala over a period of 2 years from November 2014 to October 2016. 100 newly diagnosed HIV reactive subjects as per NACO guidelines but not on ART of age 20 years and above were included in Group A while 100 subjects of similar age group on ART for 6 months included in group B. The subjects having thyroid disease, Diabetes Mellitus, Hypertension and those on hypolipidemic drugs were excluded from the study. Lipid profile was estimated biochemically and CIMT was measured using high resolution B mode ultrasonography system. Data generated from the study was analyzed according to standard statistical methods. Non normaldistribution variables were applied MannWhitney rank sum testand normal distributed variables by't' test. Pearson product-moment correlation coefficient was applied to measure the correlation between two variables. Result: The study observed a significant higher levels of Serum Total Cholestrol (TC) (182.13+24.88 mg/dl Vs 160.69+18.49 mg/dl), Triglycerides (TG) (162.70+26.15 mg/dl vs 141.23+22.99 mg/dl), Low density lipoprotein cholesterol (LDL¬-c) (110.72+22.76 mg/dl vs 94.30+16.89 mg/dl), Very low density lipoprotein(VLDL-c)(32.54+5.23 mg/dl vs 28.21+4.62 mg/dl), High density lipoprotein cholesterol (HDL¬-c)(39.66+3.36 mg/dl vs 38.18+3.83 mg/dl) and CIMT(0.93+0.145 mm vs 0.85+0.138 mm) among subjects on ARTas compared to newly diagnosed HIV reactive subjects. Conclusion: It is evident from our study that there was significantly greater prevalence of dyslipidemia in HIV reactive patients on ART as compared to newly diagnosed HIV reactive patients though it was there in both. Our study also suggested the role of HAART in the development of carotid atherosclerosis in HIV patients. HAART has dramatically reduced the morbidity and the mortality in HIV infected patients but we should not overlook these possible complications related to dyslipidemia and carotid atherosclerosis. Hence, a periodical screening and long term follow up of all the HIV patients who are on ART should be done to assess and timely detect risks associated with them.