Highly active antiretroviral therapy and dyslipidemia in people living with HIV/AIDS in Fako Division, South West Region of Cameroon

Background: The advent of HAART has been associated with a profound reduction in morbidity and mortality from HIV/AIDS. However, side effects and toxicities associated with HAART may lead to an increased risk for cardiovascular diseases. The aim of this study was to determine the prevalence of dyslipidemia and determining factors of derangements in lipid profile associated with the use of HAART regimens in people living with HIV/AIDS in Fako Division of the South West Region of Cameroon. Methods: This cross-sectional study was conducted between March and August 2014. Lipid profile was determined after overnight fast and dyslipidemia diagnosed according to the US National Cholesterol Education Program III criteria. Socio-demographic characteristics were also collected using a questionnaire. Data was analyzed using STATA; chi-square test, student's t-test, ANOVA and logistic regressions were computed. Results: Two hundred and nine participants were recruited including 157 (75.1%) on HAART and 52 (24.9%) HAART-naïve. Antiretrovirals were drugs containing two nucleoside backbones (zidovudine/ /lamivudine/tenofovir) with either a non-nucleoside (nevirapine/efavirenz) or a protease inhibitor (lopinavir). No patient was treated with statins. Their mean age was 43.4 (±11.0) years. The mean CD4⁺ T cell count was 425 (±281) cells/μl after mean duration of HIV infection of 54.8 (±43.9) months and mean duration on ART of 63.7 (±41.4) months. The prevalence of total cholesterol (≥200mg/dL) was 51.0% in patients on HAART and 9.6% pre-HAART patients (p<0.0001), whereas LDL-cholesterol ≥130mg/dL occurred in 36.9% and in 7.7% respectively, (p=0.0001). Receiving HAART (adjusted odds ratio =6.24, 95%CI: 2.33-17.45, p<0.0001) and HIV duration of 42months and more (aOR=2.26, 95%CI: 1.16-4.42, p=0.017) were independently associated with total cholesterol ≥200mg/dL. Receiving HAART (aOR=5.28,95% CI: 1.17-16.32, p=0.004) was independently associated with raised LDL-cholesterol values. The adjusted odds ratio (95 % CI) of BMI ≥25.0kg/m² versus BMI <25.0kg/m² was 3.25 (1.44-7.34) for triglycerides ≥150mg/dL. Conclusion: HAART regimens were significantly associated with atherogenic lipid profile. Lipid profile should be monitored in HIV/AIDS patients on therapy so that any negative effects of HAART are optimally managed.