Lipid Profile of Anti-Retroviral Treatment-Naive HIV-Infected Patients in Jos, Nigeria

Background : Human immunodeficiency virus (HIV) infection and its treatment are associated with lipid abnormalities. Data on lipid profile of treatment-nave HIV-infected patients in Nigeria are limited, and available studies did not exclude the role of major host-related risk factors for dyslipidemia. Aim: We assessed the lipid profile of normotensive, non-diabetic, and non-obese treatment-nave HIV-infected patients to identify their abnormalities in comparison with age- and sex-matched HIV-negative control. Subjects and Methods : One hundred and six normotensive, non-diabetic, and non-obese HIV positive patients and 98 age-and sex-matched HIV-negative controls had lipid profile estimation in the fasting state. The CD4 cell count of the HIV-infected patients was also quantified. Results : The median (IQR) triglyceride was significantly higher in HIV-positive patients than in the controls [1.75 (1.30-2.40) mmol/L vs. 1.55 (1.30-1.90) mmol/L, P = 0.01]. HIV-positive patients also had significantly lower mean total cholesterol, TC [4.18 (1.04) mmol/L vs. 4.64 (1.01) mmol/L, P = 0.001] and HDL-C [1.17 (0.35) mmol/L vs. 1.29 (0.43) mmol/L, P = 0.03]. The mean LDL-C [2.20 (0.87) mmol/L vs. 2.19 (0.75) mmol/L, P = 0.97] and TC/HDL-C ratio [3.95 (1.42) vs. 3.84 (1.14) mmol/L, P = 0.52] were similar between the HIV-positive patients and controls. The HIV-infected patients had a significantly higher proportion of subjects with low HDL-C [36.8% (39/106) vs. 23.5% (23/98), P = 0.04] and hypertriglyceridemia [31.1% (33/106) vs. 11.2% (11/98), P = 0.001] while the controls had significantly higher proportion of subjects with hypercholesterolemia [22.4% (22/98) vs. 10.4% (11/106), P = 0.02]. Lower HDL-C was associated with CD4 cell count < 200 cells/mL ( P = 0.02). Conclusion : Lipid abnormalities are common in treatment-nave HIV-infected patients even in the absence of major host-related risk factors for dyslipidemia. HIV-infected patients should, therefore, be routinely screened for lipid disorders before commencement of anti-retroviral therapy.