Prevalence and predictors of dyslipidemia on highly Active antiretroviral therapy and highly active Antiretroviral therapy naive hiv positive persons in Defence hospital, addis ababa –ethiopia

Abstract

Background: The introduction of highly active antiretroviral therapy (HAART) has led to a marked reduction in AIDS-related morbidity and mortality. However HAART, has been reported to be associated with a number of side effects in HIV positive persons among which dyslipidaemia and lipodystrophy are common metabolic disorders. Objective: To assess prevalence and predictors of dyslipidemia on HAART and HAART naïve HIV-positive persons in Defense Hospital, Addis Ababa-Ethiopia from September 20 to October 23, 2013. Methodology: A facility based comparative cross-sectional study on 228 HIV positive persons on HAART and HAART naïve was conducted from September 20 to October 23, 2013. Ethical approval and clearance was obtained from college of public Health and Medical Sciences Jimma University. Socio-demographic, clinical and laboratory data were collected by a structured questionnaire. A fasting blood sample of 5 milliliter was taken and from this 2.5 milliliter was used for lipid profile and the rest for CD4 analysis. Dyslipidemia was defined as the presence of any of TC ≥ 200 mg/dl, HDL-c < 40 mg/dl, LDL-c ≥ 130 mg/dl, TG ≥ 150mg/dl. For statistical analysis student’s t-test and logistic regression were done using Statistical Package for Social Sciences (SPSS) Version 16.00. Result: Total number of participants enrolled in the study were 228, in which 103 (45%) males and 125 (55%) females. From the participants 114 HIV-positive persons who were on HAART in one group & 114 patients were HAART naïve in the second group were included. The mean value of TC was(202.4 & 186.7), HDL-c(40.5 & 43),LDL-c(126 & 111.4),TG (176 &155) for HAART and HAART naïve respectively. Among the participants involved in the study 84 (73.7%) on HAART and 61 (53.5%) HAART naive persons had at least one lipid abnormality. The prevalence of TC≥ 200mg/dl was 50% & 30%; HDL< 40mg/dl was 43.8% & 36%; LDL-c≥130mg/dl was 48.3% & 28.1%; TG ≥150mg/dl 59.6% & 39% among those on HAART and HAART naïve respectively. Duration of therapy was significantly and positively associated with TC, LDL-c & TG in which the adjusted odds ratio (95% CI) of duration of therapy was 0.54(0.02-0.36) for TC