Determination of Lipid Derangements in Human Immunodeficiency Virus Patients Undergoing Anti-Retroviral Therapy

Article Information

Title: Determination of Lipid Derangements in Human Immunodeficiency Virus Patients Undergoing Anti-Retroviral Therapy

Authors: Qamar Bashir, Zujaja Hina Haroon, Naveed Asif, Muhammad Qaiser Alam Khan, Eijaz Ghani, Syed Raza Jaffar

Journal: Pakistan Armed Forces Medical Journal (PAFMJ)

HEC Recognition History

Category	From	To
Y	2024-10-01	2025-12-31
Y	2023-07-01	2024-09-30
Y	2021-07-01	2022-06-30
Y	2020-07-01	2021-06-30
Y	1900-01-01	2005-06-30

Publisher: Army Medical College, Rawalpindi.

Country: Pakistan

Year: 2022

Volume: 72

Issue: 6

Language: English

DOI: 10.51253/pafmj.v72i6.5810

Keywords: CholesterolHyperlipidemiaAcquired immunodeficiency syndrome (AIDS)Antiretroviral therapy (ART)Human immunodeficiency virus (HIV)

Abstract

Objective: To determine lipid derangements in HIV-positive patients receiving anti-retroviral therapy (ART).
Study Design: Comparative cross-sectional study.
Place and Duration of study: Chemical Pathology Department, in cooperation with the Department of Virology at Armed Forces Institute of Pathology (AFIP), Rawalpindi Pakistan, from Mar 2019 to Mar 2020.
Methodology: In this study, two groups were made. In Group-1, lipid profile estimation was done in HIV patients without treatment. In contrast, lipid profile estimation was done after one year of treatment with anti-retroviral drugs in Group-2.
Results: One hundred and two HIV-positive subjects were included in our study. Of these patients, 88(86.27%) were males,and 14(13.73%) were females. Independent sample t-test revealed a statistically significant difference (p-value&lt;0.05) in serum cholesterol, serum triglycerides, serum high-density lipoprotein (HDL-c), low-density lipoproteins (LDL) and very lowdensity lipoproteins (VLDL) between the two groups.
Conclusion: Hyperlipidemia in HIV patients getting anti-retroviral therapy (ART) exposes them to a high risk of coronary artery diseases and myocardial infarction. Hence lipid profile of patients getting ART must be regularly monitored, and hyperlipidemia, if present, should be managed.

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Research Objective

To determine lipid derangements in HIV-positive patients receiving anti-retroviral therapy (ART).

Methodology

A comparative cross-sectional study was conducted at the Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from March 2019 to March 2020. 102 HIV-positive adult subjects were divided into two groups: Group-1 (56 subjects) with no ART treatment, and Group-2 (46 subjects) after one year of ART treatment. Lipid profiles (serum cholesterol, triglycerides, HDL-c, LDL, and VLDL) were estimated using spectrophotometry on an automated chemistry analyzer. Data was analyzed using SPSS version 23.0, with an independent sample t-test used for comparison between groups.

Methodology Flowchart

                        graph TD;
    A["Recruit HIV+ Patients"] --> B["Divide into Groups"];
    B --> C["Group 1: No ART - Lipid Profile Estimation"];
    B --> D["Group 2: 1 Year ART - Lipid Profile Estimation"];
    C --> E["Data Analysis SPSS, t-test"];
    D --> E;
    E --> F["Compare Lipid Profiles"];
    F --> G["Draw Conclusions"];

Discussion

The study findings align with previous research indicating that ART is associated with hyperlipidemia in HIV patients. The observed derangements in lipid profiles are attributed to ART's effects on lipid metabolism, mitochondria, endothelial, and adipocyte cell function. These changes increase the risk of cardiovascular diseases and myocardial infarction.

Key Findings

Statistically significant differences (p-value < 0.05) were observed in serum cholesterol, serum triglycerides, HDL-c, LDL, and VLDL between HIV patients with and without ART. Specifically, patients on ART showed raised levels of serum cholesterol, TG, LDL-c, and VLDL-c, and decreased HDL-c levels.

Conclusion

Hyperlipidemia in HIV patients receiving ART poses a significant risk for coronary artery diseases and myocardial infarction. Regular monitoring of lipid profiles in patients on ART is crucial, and hyperlipidemia, if present, should be managed.

Fact Check

- The study included 102 HIV-positive subjects.
- 88 (86.27%) of the included patients were males, and 14 (13.73%) were females.
- The study was conducted from March 2019 to March 2020.

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