Prevalence of Dyslipidemia in HIV Patients and HIV Patients receiving Highly Active Anti - Retroviral Therapy: Cross Sectional Comparative study

Anoob John, K A (2009) Prevalence of Dyslipidemia in HIV Patients and HIV Patients receiving Highly Active Anti - Retroviral Therapy: Cross Sectional Comparative study. Masters thesis, Madurai Medical College, Madurai.

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Abstract

This prevalence study was conducted in the background that dyslipidemia and cardiovascular mortality is reported to increase in HIV patients especially on Anti-retroviral therapy. In this study 126 patients who were attending the Antiretroviral therapy centre GRH Madurai & Medicine wards were included and divided into five different groups according to the anti retroviral therapy after obtaining Ethical Committee clearance from the institution. Patients with HIV infection were initiated on Anti-retroviral therapy based on WHO guidelines. Patients who were exposed to HAART for more than 2 years were selected in the treatment group and compared to age and sex matched treatment naïve group. Biochemical and anthropometric analysis were done and results entered in master chart which was statistically analyzed using computer and EPI 2002 software. The results of the study showed an increased prevalence of disease among the 30-39 age group with increased prevalence a among males in the HAART groups. The Anthropometric parameters on analysis showed a mean BMI of both HAART and treatment naive Groups in the low normal range. Waist Hip ratio revealed mean of 0.952 HAART groups and 0.875 in treatment naïve group. This showed a significant correlation to Waist hip ratio and the disease while fall in BMI was seen rather than an increase in BMI. The lipid analysis showed a significant increase in the total cholesterol, LDL and VLDL in both the HAART groups and treatment naïve groups. There was an insignificant fall in HDL levels in both groups. The abnormalities in lipid were more in HAART group especially the stavudine and efavirenz based regimes. When both drugs were present together as in Group II, patients had the maximum alteration in lipid levels. The Group II followed by Group IV Group I and Group III are in decreasing order of lipid abnormalities noticed in the study. The mean total cholesterol was 244.5mg%, 222mg%. 196 mg% 178 mg% in the Group II, Group IV, Group I and Group III respectively p value is significant. Similarly there was statistically significant increase in LDL, TGL and VLDL. On basis of many studies now PI are now reserved for failure of primary regimen. Patients on PI developing metabolic derangements nevirapine is a better substitute than efavirenz. Similarly studies have show proven benefit by switching stavudine with tenofovir and abacavir with equally good viral suppression and less dyslipidemia. The strategies like screening and monitoring the lipid every 6 months, switching to lipid friendly drugs, lipid modifying drugs as well as change in life style may help to nullify the increased cardiovascular risk and mortality in HIV patients.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Prevalence ; Dyslipidemia ; HIV Patients ; HIV Patients ; Highly Active Anti Retroviral Therapy (HAART) ; Cross Sectional Comparative Study.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 15 Mar 2018 15:56
Last Modified: 15 Mar 2018 15:56
URI: http://repository-tnmgrmu.ac.in/id/eprint/6258

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