Serum lipid profiles of patients taking efavirenz based antiretroviral regimen compared to ritonavir-boosted atazanavir with an optimized back ground at Zewditu Memorial Hospital, Addis Ababa, Ethiopia

Abstract

Background: Dyslipidemia represent significant health care concerns in Human immune deficiency virus (HIV) infected patients taking highly active 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 lipid profile changes of HIV patients on ATV/r-based regimen compared to efavirenz (EFV)-based regimen, while the background nucleos/tide backbone is optimized.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. Equal number of EFV and ATV/r-treated patients (n = 90 each) taking for one year and above were included in the study. Serum lipid parameters (triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C)) were measured using fully automated mind ray, Chemistry analyzer. Data comparison used chi-square test, Student t-test and Mann-Whitney U test. Multivariate regression analysis and p-value<0.05 was used to identify associated factors of serum lipid profiles.Results: In the present study ATV/r-treated group resulted 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 ratio (6.6 vs. 4.4; p=0.001) as compared to EFV-treated group. EFV-treated group showed significantly higher in the mean value of HDL-C (44.7 vs. 38.7mg/dL; p= 0.001) as compared to ATV/r-treated group. No significant difference was found in TC (p=0.5), LDL-C (p=0.6), TC/HDL-C (p=0.5) and LDL-C/HDL-C (p=0.1) between EFV and ATV/r-treated patients. In ATV/r-treated patients, CD4 count and body mass index (BMI) was significantly associated with TC. In EFV-treated patients, BMI was significantly associated with increased serum LDL-C and TC in female participants.Conclusion: In conclusion, ATV/r raises TG and TG/HDL-C while, HDL-C was higher in EFV than ATV/r-treated group. Both groups have less atherogenic lipid profiles in terms of TC/HDL-C and LDL/HDL-C.

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 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 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.…”

Dyslipidemia among adult HIV patients on antiretroviral therapy and its association with age and body mass index in Ethiopia: A systematic review and meta-analysis

“…When we pooled them, age was statistically associated with high LDL-c (OR = 3.34, 95%CI: 2.02, 5.52), I 2 = 0.0%. Furthermore, the pooled effect of four studies [27,29,30,35] showed that BMI � 25 was associated with elevated levels of LDL-c (OR = 3.27, 95%CI: 2.15, 4.96), I 2 = 0.0% (Fig 9).…”

“…Furthermore, two studies in Amhara region reported the association of TC and CD4 counts but they used different cut off points that hinders us to do pooled effect analysis. Fiseha T et al depicted that CD4 count less than 200 was significantly associated with TC [29], whereas Muche AB et al found the significant association of CD4 count less than 455 and TC [35].…”

“…We identified 15 cross-sectional and 2 prospective cohort studies. Studies of 12 with 2638 participants, 14 consisting of 2928 participants, and 17 having 3929 participants were included in the pooled meta-analysis of dyslipidemia [8,[23][24][25][26][27][28][29][30][31][32][33], both TC and LDL-c [8,[23][24][25][26][27][28][29][30][31][32][33][34][35], and both TGs and HDL-c [2,8,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37], respectively.…”