HIV感染患者中高效抗逆转录病毒治疗相关代谢异常和脂肪代谢障碍的患病率。

Prevalence of highly active antiretroviral therapy associated metabolic abnormalities and lipodystrophy in HIV infected patients.

作者信息

Feleke Yeweyenhareg, Fekade Daniel, Mezegebu Yared

机构信息

Endocrinology and Metabolism Unit, Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

出版信息

Ethiop Med J. 2012 Jul;50(3):221-30.

PMID:23409405

Abstract

BACKGROUND

Highly active antiretroviral therapy (HAART) improves the longevity of HIV patients. However, the side effect of the drugs leads to development of chronic metabolic and cardiovascular complications.

OBJECTIVE

The aim of the study was to determine the prevalence and risk factors of the metabolic abnormalities and lipodystrophy among adult Ethiopian HIV infected patients on ART for one year and above.

METHODS

A cross-sectional study was conducted among HIV infected patients on HAART for one year or more, attending the ART clinics of Tikur Anbessa Specialized hospital in Addis Ababa. A total of consecutive 356 HIV infected patients volunteered to participate in the study from July 2007 to January 2008. Data was collected using clinical interview technique on structured questionnaires and physical examination of the patient, 319 had biochemical tests performed.

RESULTS

Three hundred fifty six HIV patients; 261 (73.1%) females and 95 (26%) males were studied. Two hundred nine (59.7%) patients were on Stavudine based and 135 (41.3%) were on Zidovudine based ART therapy. The overall prevalence of lipodystrophy was 68.3% (243), prevalence of hyperlipademia among 319 HIV patient was 56.9% Among these, the prevalence of hypercholesterolemia was 38.2%, high LDL cholesterol was 54.2% hypertryglyceredimeia was 15.2% Fasting hyperglycemia was 17.8% (IFG in 10.9% and overt diabetes in 6.9%). History of smoking was significantly associated with lipoatrophy and lipohypertrophy. ART regimen d4T was significantly associated with lipoatrophy. Duration of ART treatment > or = 1 yr was significantly associated with both lipoatrophy, lipohypertrophy and hypertriglyceredemia.

CONCLUSIONS AND RECOMMENDATIONS

Lipodystrophies occurred in majority of patients on ART treatment for longer than one year, hyperlipaedemia and hyperglycaemia were also seen commonly in Ethiopian HIV patients on HAART. We recommend careful monitoring of metabolic abnormalities, examination of the patient for early detection of the side effect, change of the offending agents management of metabolic abnormalities.

摘要

背景

高效抗逆转录病毒疗法（HAART）可提高HIV患者的寿命。然而，药物的副作用会导致慢性代谢和心血管并发症的发生。

目的

本研究旨在确定接受抗逆转录病毒治疗一年及以上的成年埃塞俄比亚HIV感染患者中代谢异常和脂肪代谢障碍的患病率及危险因素。

方法

对在亚的斯亚贝巴提库尔·安贝萨专科医院抗逆转录病毒治疗门诊接受HAART治疗一年或更长时间的HIV感染患者进行了一项横断面研究。2007年7月至2008年1月，共有356例连续的HIV感染患者自愿参与研究。通过临床访谈技术，采用结构化问卷对患者进行数据收集，并对患者进行体格检查，其中319例患者进行了生化检测。

结果

研究了356例HIV患者，其中女性261例（73.1%），男性95例（26%）。209例（59.7%）患者接受基于司他夫定的治疗，135例（41.3%）患者接受基于齐多夫定的抗逆转录病毒治疗。脂肪代谢障碍的总体患病率为68.3%（243例），319例HIV患者中高脂血症的患病率为56.9%。其中，高胆固醇血症的患病率为38.2%，高LDL胆固醇的患病率为54.2%，高甘油三酯血症的患病率为15.2%，空腹血糖升高的患病率为17.8%（空腹血糖受损为10.9%，显性糖尿病为6.9%）。吸烟史与脂肪萎缩和脂肪增生显著相关。抗逆转录病毒治疗方案d4T与脂肪萎缩显著相关。抗逆转录病毒治疗持续时间≥1年与脂肪萎缩、脂肪增生和高甘油三酯血症均显著相关。