Development of Metabolic Risk Factors after Initiation of Second Line Anti-Retroviral Therapy

April 2013
Australasian Medical Journal;Apr2013, Vol. 6 Issue 4, p241
Academic Journal
Introduction Highly Active Anti-Retroviral Therapy (HAART) is accompanied with several metabolic effects like adipose redistribution and insulin resistance. HAART has reduced the number of deaths but is associated with increased risk of strokes and heart attacks. We did this study to examine the association of HAART and lipodystrophy.. Materials and Methods The study design was cross sectional. Subjects were HIV infected patients from hospitals of Kasturba Medical College Mangalore. 26 patients were on protease inhibitors for at least 6 months and 14 were drug naive patients. Assessment of lipodystrophy, fasting blood sugar and fasting lipid profile was done (blood was collected after minimum of 8 hours of fasting) and these parameters were compared in two groups. The collected data was analysed using SPS version 11.5. We did chi2 test for binary data and for student "t" test for continuous data. P value less than 0.05 was considered significant. Results There was elevation in total cholesterol level (172.65±47.609mg/dl) in individuals on protease inhibitor versus drug naive patients (141.36±7.70mg/dl),(p=0.020) .There was significant elevation in Low Density Lipoprotein (0.029) and decrease in High Density Lipoprotein level (p=0.012) in individuals on protease inhibitors. The levels of High Density Lipoproteins decreases with increase in duration of protease inhibitors i.e. individuals who were on protease inhibitors for less than two years had mean High Density Lipoprotein (29.05±15.71 mg/dl) versus those who are on treatment for more than 5 years (14.02±22.16), (p=0.025) and Low Density Lipoprotein levels increase with duration of Anti-Retroviral Therapy those who were on treatment less than 2 years mean LDL(102.18±39.32) versus those on treatment for more than 5 years (127.38±22.66);(p=0.10). Conclusions Human immunodeficiency virus infection is related to metabolic complications which are aggravated by using second line anti-retroviral therapy. All HIV infected patients receiving protease inhibitors must have their glucose and lipids measured periodically.


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