Njoroge Anne, Guthrie B L, Bosire Rose, Wener Mark, Kiarie James, Farquhar Carey
Department of Research and Programs, Kenyatta National Hospital, Nairobi, Kenya.
University of Washington, Seattle, WA, USA.
Lipids Health Dis. 2017 Jun 9;16(1):110. doi: 10.1186/s12944-017-0503-9.
Antiretroviral treatment (ART) is associated with dyslipidemia yet little is known about the burden of dyslipidemia in the absence of ART in sub-Saharan Africa. We compared the prevalence and risk factors for dyslipidemia among HIV-infected ART-naïve adults and their uninfected partners in Nairobi, Kenya.
Non-fasting total cholesterol (TC) and high density lipoprotein cholesterol (HDL) levels were measured by standard lipid spectrophotometry on thawed plasma samples obtained from HIV-infected participants and their uninfected partners. Dyslipidemia, defined by high TC (>200 mg/dl) or low HDL (<40 mg/dl) was compared between HIV-infected and uninfected men and women.
Among 196 participants, median age was 32 years [IQR: 23-41]. Median CD4 count among the HIV-infected was 393 cells/ μl (IQR: 57-729) and 90% had a viral load >1000 copies/ml. Mean TC and HDL were comparable for HIV-infected and uninfected participants. Prevalence of dyslipidemia was 83.8% vs 78.4% (p = 0.27). Among the HIV-infected, those with a viral load >1000 copies/ml were 1.5-fold more likely to have dyslipidemia compared to those with ≤1000 copies/ml (adjusted prevalence ratio [aPR] 1.5, 95% CI: 1.22-30.99, p = 0.02). BMI, age, gender, blood pressure and smoking were not significantly associated with dyslipidemia.
Among ART-naïve HIV-infected adults, high viral load and low CD4 cell count were independent predictors of dyslipidemia, underscoring the importance of early initiation of ART for viral suppression.
抗逆转录病毒治疗（ART）与血脂异常有关，但在撒哈拉以南非洲地区，关于未接受ART治疗时血脂异常的负担知之甚少。我们比较了肯尼亚内罗毕未接受ART治疗的HIV感染成人及其未感染伴侣中血脂异常的患病率和危险因素。
通过标准脂质分光光度法对从HIV感染参与者及其未感染伴侣处获得的解冻血浆样本测量非空腹总胆固醇（TC）和高密度脂蛋白胆固醇（HDL）水平。比较HIV感染和未感染的男性及女性中由高TC（>200mg/dl）或低HDL（<40mg/dl）定义的血脂异常情况。
在196名参与者中，年龄中位数为32岁[四分位间距：23 - 41]。HIV感染者的CD4细胞计数中位数为393个/μl（四分位间距：57 - 729），90%的患者病毒载量>1000拷贝/ml。HIV感染和未感染参与者的平均TC和HDL水平相当。血脂异常的患病率分别为83.8%和78.4%（p = 0.27）。在HIV感染者中，病毒载量>1000拷贝/ml的患者发生血脂异常的可能性是病毒载量≤1000拷贝/ml患者的1.5倍（校正患病率比[aPR] 1.5，95%置信区间：1.22 - 30.99，p = 0.02）。BMI、年龄、性别、血压和吸烟与血脂异常无显著关联。
在未接受ART治疗的HIV感染成人中，高病毒载量和低CD4细胞计数是血脂异常的独立预测因素，这突出了早期启动ART进行病毒抑制的重要性。
