BIOCHEMICAL RISK FACTORS FOR CARDIOVASCULAR DISEASE IN HIV-INFECTED PATIENTS WITH AND WITHOUT ANTIRETROVIRAL TREATMENT AT THE LAGOS UNIVERSITY TEACHING HOSPITAL

Abstract

Background: Cardiovascular risk factors are prevalent in HIV-infected patients and this places
them at increased risk for cardiovascular disease (CVD). Early identification of these risk
factors should lead to prompt intervention to avert CVD. Traditional and novel biochemical
parameters can be applied in combination for the cardiovascular risk assessment of these
patients. Therefore this study aims to determine the biochemical risk factors for CVD in HIV
infected patients with and without antiretroviral therapy (ART), which would be useful in the
management of HIV-infected patients.

Method: This was a descriptive, cross-sectional study of HIV-infected patients at the Lagos
University Teaching Hospital. Fasting lipid profile and plasma glucose, homocysteine and
hsCRP were determined. Student’s t-test was used to compare the mean of each subject group
to the control. Relationship was tested with Pearson correlation coefficient and p <0.05 was
considered to be statistically significant.

Results: A total of 253 subjects (152 females, 101 males) were recruited for this study (100
HIV-infected treatment-naive, 100 HIV-infected treated and 53 HIV negative controls).
Dyslipidaemia was prevalent (8% – 43%) in the subject groups with the following serum lipid
profiles: HIV naïve (low HDL-C) and HIV treated (borderline high TG, TC, LDL-C); with
resultant high CVD risk ratios in both groups. Hyperhomocysteinaemia was prevalent in the
HIV naïve and HIV treated subjects at 35% and 39% respectively, with serum levels in both
groups significantly higher than their controls (p <0.001); while there was a prevalence of
increased hsCRP of 45% and 11% respectively, but had significantly higher serum levels in
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only the HIV naïve group (p <0.001). None of the biochemical parameters was significantly
correlated with HIV viral load or antiretroviral therapy.

Conclusion: The biochemical risk factors for cardiovascular disease (dyslipidaemia,
hyperhomocysteinaemia, increased hsCRP) have been demonstrated in HIV-infected patients,
with no relationship with HIV viral load and antiretroviral therapy. Therefore, the routine
monitoring of the combined traditional and new biochemical risk factors, irrespective of the
retroviral and therapy status, is necessary to improve the risk assessment of CVD in HIV
infected patients.

BIOCHEMICAL RISK FACTORS FOR CARDIOVASCULAR DISEASE IN HIV-INFECTED PATIENTS WITH AND WITHOUT ANTIRETROVIRAL TREATMENT AT THE LAGOS UNIVERSITY TEACHING HOSPITAL