HAART and Lipid Metabolism in a Resource Poor West African Setting

Highly active antiretroviral therapy (HAART) confers several benefits, including reduction in viral load and longevity in HIV positive patients. However, Metabolic and morphological complications have been increasingly reported among patients in the advanced industrialized countries receiving chronic HAART up to 10-20years. We report occurrence of hyperlipidaemia in subjects on HAART in a West African Community. The CD4+ cell count and fasting lipid profile were estimated in One hundred and ten (110) HIV positive patients attending the HIV clinic of Obafemi Awolowo College of Health Sciences, Sagamu. Fifty five subjects served as the study subjects and were selected randomly from the patients on triple combination therapy of ARV medication for a minimum of 3 years and matched for age and sex with the control group (55) of those who were not on ARV medication. All the subjects were symptomatic grade 3 or 4 WHO classification. The CD4 count of the study was 355.11 cells/mm³± 185.0 and was statistically significantly higher than the CD4 count of the control subjects which was 177.95 cells/mm³ ± 59.1 (P<0.05). The mean values for VLDL, LDL, Cholesterol, and triglyceride concentrations were 32.9mg/dl ± 8.9, 75.9mg/dl ± 45.8, 142.3mg/dl ± 48.6, 163.6mg/dl ± 44.5 in study group respectively and were statistically significantly higher than 30.3mg/dl ± 1.2, 48.9mg/dl ± 34.4, 114.6 mg/dl ± 35.8, 150.5mg/dl ± 37 in the control group. (P<0.05) The mean concentration of HDL of 36.0 mg/dl ± 13 in the control subjects was significantly higher than 29.7mg/dl ± 8.9 in the study (P>0.05). The prevalence of hypertryglyceridemia (>200mg/dl) was 15%.in the study group and 2.5%.in the control.

Keywords
dyslipidaemia, limited resource settings, hypertryglyceremia, hypercholesteremia, HAART, lipid concentration