A Follow-up Study to Evaluate Lipids as Cost-Effective Markers in HIV-Infected Patients on Antiretroviral Therapy

Background: Human immunodeficiency virus (HIV) infection per se and antiretroviral therapy (ART) both are associated with dyslipidemias, one of the important risk factors in the development of premature atherosclerosis and coronary artery disease. Certain classes of highly active antiretroviral therapy (HAART), especially protease inhibitors, are more frequently associated with dyslipidemia. The objectives of this study were to evaluate and compare lipid profile – total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglyceride in HIV patients before and after starting ART and also to correlate lipid profile and CD4 counts in HIV infection, thus evaluating the feasibility of using lipid profile to monitor the progression of infection in HIV-infected patients as an adjunct to CD4 counts in resource-limited settings. Methods: Paired samples of 100 newly diagnosed HIV patients were taken before and after treatment with HAART. CD4 cell counts and lipid parameters measured and compared using paired 't'-test. Each of the lipid parameter correlated with CD4 cell count. Results: Significant increase was seen in the levels of TC and HDL-C (P < 0.05) with treatment. CD4 cell count also showed a significant increase (P < 0.05) with therapy. HDL-C levels correlated significantly with CD4 cell counts in pretreatment group (r = 0.23, P = 0.020, 95% C.I.). Conclusion: Combination of zidovudine, lamivudine, and nevirapine is associated with significant increase in HDL-C. HDL-C levels are a good indicator of disease severity in HIV-infected patients before starting the therapy.