Metabolic abnormalities in adult HIV infected population on antiretroviral medication in Malaysia: a cross-sectional surveyReport as inadecuate




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BMC Public Health

, 13:758

Health behavior, health promotion and society

Abstract

BackgroundIn the current two decades, dyslipidemia and increased blood glucose as metabolic abnormalities are the most common health threats with a high incidence among HIV-AIDS patients on antiretroviral ARV treatment. Scientific investigations and reports on lipid and glucose disorders among HIV infected communities are inadequate especially in those developing such as Malaysia. This cross-sectional survey was mainly aimed to evaluate the prevalence of metabolic abnormalities and associated risk factors among HIV infected population patients on ARV medication.

MethodsIn a single reference health center in Malaysia, 2739 adult HIV positive patients on antiretroviral therapy ART were studied cross-sectionally using medical records. Besides demographic variables and associated health disorders, those factors which can change the lipid and glucose levels were collected. Logistic Regression was used to find the potential risk factors p < 0.05.

ResultsMajority of the studied population were male 81.1% and aged between 30–49 68.6%. Mean CD4 count was 474.25 cells-mm while undetectable RNA viral load was common among 83.3 % of subjects. Among 1,583 patients with the recent blood lipid and glucose tests, increased levels of triglyceride TG and total cholesterol TC were frequently prevalent in half of the population as 59 % and 54.2 % while 28.7 %, 35.1 % and 38.2 % had declined level of high-density lipoprotein HDL, raised low-density lipoprotein LDL and fasting plasma glucose FPG which were less common. Dyslipidemia was common in 82.3 % of the subjects. Notably, medication with protease inhibitor PI was a potential risk for elevated triglyceride odds ratio OR = 2.309, 95% confidence interval CI = 1.605–3.324, P = 0.001, high TC OR = 1.561, 95% CI = 1.123–2.169, P = 0.008 and low HDL OR = 1.449, 95% CI = 1.037–2.024, P = 0.029. As lifestyle factor, alcohol consumption results as significant risk factor for raised TG OR = 2.653, 95% CI = 1.353–5.202, P = 0.004. Also having hepatitis raised risk of high FPG level OR = 1.630, 95% CI = 1.197-2.220, P = 0.002 in this sample population.

ConclusionsDyslipidemia is highly common in Malaysian HIV subjects receiving ARV medication. Lifestyle modification, changing PI and switch to other ARV regimen can help in reduction of these abnormalities. Also suitable strategies and plans are necessary to prevent cardiovascular diseases in future.

KeywordsLipid disorders Metabolic abnormalities Fasting plasma glucose ARV medication Protease inhibitor Cardiovascular disease Dyslipidemia HIV positive Malaysia AbbreviationsAIDSAcquired immune deficiency syndrome

ARTAntiretroviral therapy

ARVAntiretroviral

BMIBody mass index

FPGFasting plasma glucose

HAARTHighly active antiretroviral therapy

HDLHigh-density lipoprotein

HIVHuman immunodeficiency virus

LDLLow-density lipoprotein

TCTotal cholesterol

TGTriglyceride.

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Author: Nazisa Hejazi - Roslee Rajikan - Christopher Lee Kwok Choong - Suzana Sahar

Source: https://link.springer.com/







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