Serum Lipid Profiles of Patients Taking Efavirenz-Based Antiretroviral Regimen Compared to Ritonavir-Boosted Atazanavir with an Optimized Background at Zewditu Memorial Hospital, Addis Ababa, Ethiopia

Abstract

Background Dyslipidemia represents significant health care concerns in patients taking antiretroviral therapy due to their association with cardiovascular disease risk. There is limited data regarding the effects of boosted atazanavir (ATV/r) treatment in the lipid profiles of Ethiopian HIV patients. Thus, this study compares the mean values of lipid profile differences of HIV patients on ATV/r-based regimen compared to efavirenz (EFV)-based regimen, while the background is Tenofovir Disoproxil Fumarate/lamivudine. Materials and Methods A comparative hospital-based cross-sectional study was conducted among adult HIV-infected patients at Zewditu Memorial Hospital, Addis Ababa, Ethiopia, from July–September 2017. An equal number of EFV and ATV/r-treated patients (n=90 each) receiving for 1-year and over were included in the study. Serum total cholesterol (TC), triglyceride (TG), gigh-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c) were measured. Data comparison used chi-square test, Student’s t -test and Mann–Whitney U -test. Multivariate logistic regression analysis and p -value<0.05 were used to identify associated factors of serum lipid profiles. Results In the present study, the ATV/r-treated group results were significantly higher in the median values of TG [207 (56–1094) vs 145 (42–768) mg/dL; p =0.001] and the mean value of TG/HDL-c (6.6 vs 4.4; p =0.001) as compared to the EFV-treated group. The EFV-treated group showed significantly higher in the mean value of HDL-c (44.7 vs 38.7 mg/dL; p =0.001) as compared to the ATV/r-treated group. Body mass index was associate with LDL and HDL. CD4 was associated with TC. Current antiretroviral therapy was associated with TG. Duration of HIV since first diagnosis and duration of ART were associated with HDL. Conclusion ATV/r is associated with elevated in TG and TG/HDL-C, but low HDL as compared to EFV. Differences in LDL or HDL that were found were of unclear clinical significance. The long-term significance is unknown.

The effects of ART on the dynamics of lipid profiles in Chinese Han HIV-infected patients: comparison between NRTI/NNRTI and NRTI/INSTI

“…Indeed, with the exception of HDL-C and Lp(a), higher mean values of each serum lipid profiles were observed in HIV patients on INSTIs regimen compared with those on NNRTIs regimen. The present study is inconsistent with earlier studies conducted in Ethiopia, indicating that HIV-infected patients undergoing long-term ART regimen are more likely to have elevated HDL-C as compared with patients undergoing short-term ART regimen ( 24 , 25 ). Additionally, the present study failed to confirm the findings of the SCRIPT trial, which was significantly associated with elevated Lp(a) levels ( 14 ).…”

“…Even though there was a wide range of confounding factors and limited sample size in this study, advanced methods and sensitivity analyses were used to obtain robust analysis results. Our findings confirm and extend the results from previous observational studies, which showed that age, gender, BMI, CD4 count, and ART duration were the predictors of unfavorable lipid profiles alterations in patients on ART ( 24 , 25 , 30 , 31 ).…”

Altered Lipid Profiles and Vaccine Induced-Humoral Responses in Children Living With HIV on Antiretroviral Therapy in Tanzania

“…Previous studies (mostly done in HIV+ adults) have linked the use of protease (PI)-based ART with increased dyslipidaemia ( Cunha, 2015 ; De Lima et al., 2018 ; Irira et al., 2020 ; Belete et al., 2021 ; Hamooya et al., 2021 ; Tilahun et al., 2021 ). HIV+ individuals on PI-based regimen are more likely to have higher concentrations of triglycerides than those who were on non-PI therapies ( Kazooba et al., 2017 ; Belete et al., 2021 ).…”

“…Previous studies (mostly done in HIV+ adults) have linked the use of protease (PI)-based ART with increased dyslipidaemia ( Cunha, 2015 ; De Lima et al., 2018 ; Irira et al., 2020 ; Belete et al., 2021 ; Hamooya et al., 2021 ; Tilahun et al., 2021 ). HIV+ individuals on PI-based regimen are more likely to have higher concentrations of triglycerides than those who were on non-PI therapies ( Kazooba et al., 2017 ; Belete et al., 2021 ). In this study, we similarly observed that CLWH receiving protease-based therapy (lopinavir boosted with ritonavir) had moderately higher triglyceride levels than CLWH who were on dolutegravir, an integrase-based regimen.…”

Prevalence and predictors of glucose metabolism disorders among People Living with HIV on combination antiretroviral therapy

“…In a resource-limited setting, Efavirenz (EFV) and Atazanavir/Ritonavir (ATV/r) serve as a backbone of combination antiretroviral regimens [ 16 ]. In Ethiopia, during the study period, the preferred first-line regimen for adults was EFV-based cART, specifically a combination of tenofovir (TDF), lamivudine (3TC), and EFV [ 17 ].…”