Introduction: Long term use of antiretroviral therapy subpopulation living with HIV is associated with disturbances in plasma lipids concentrations. Lipids profiles were not routinely used to monitor treatment in the course of treatment resulting in adverse outcomes. Supportive information for the use of lipid concentrations is necessary for the day to day monitoring of people living with HIV on antiretroviral treatment. Evidence of the importance of lipid profiles in monitoring treatment was hoped to influence end users to institute routine monitoring. To this end, the prevalence and timing of dyslipidemia onset in people living with HIV/AIDS on ART Bulawayo, Zimbabwe were determined. Materials and Methods: The study was conducted at Mpilo Central Hospital OIC in Bulawayo, Zimbabwe over 3 months. A cross-sectional study was conducted in people living with HIV who were on highly active anti-retroviral treatment at Mpilo Central Hospital OIC. Lipid assays were determined by Elisa methods. Viral loads and CD4 were measured using the COBAS® TaqMan® and BD FACSCount™ Flow Cytometer, respectively. Results: A total of 149 accepting participants were enrolled with most (63.2%) being females. The median age of the respondents was 43 years and their median CD4 count was 436 cells/μL after a median duration on ART of 36 months. Viral load was <40 in the majority (68.6%) of the participants. More females (63.1%) were on HAART and were aged >35 (60.4%) years. NNRTI (90.6%) were the more commonly prescribed HAART. The prevalence of dyslipidemia was 70.2%. Hypercholesterolaemia was detected in 72 (48.3%) patients with 26 being male and 46 being female. High levels of LDL-cholesterol (LDL-c ≥ 3.0 mmol/L) were found in 115 patients with 74 of them being female. Hypertriacylglycerolaemia (TAG ≥ 2.0 mmol/L) was present in 8 cases. The proportion of patients with a low HDL-cholesterol (HDL-c < 1.0 mmol/L) was 15.3% while those with a ratio of TC/HDL-c ≥ 4.1 were 87.5%. Conclusion: The study demonstrated a high prevalence of dyslipidemia in HIV-patients receiving HAART. There is a need for the HIV program to institute laboratory monitoring of blood lipids in patients over one year on HAART. In addition, testing and development of biomarkers of other novel pathophysiological changes and HAART outcomes that may develop in the subpopulation in time, is of paramount importance as adverse drug effects are still being experienced that may necessitate regimen changes.
Dr. Greanious Alfred Mavondo
Department of Pathology, Faculty of Medicine, National University of Science and Technology, Bulawayo, Zimbabwe.