Fiseha Temesgen, Alemu Worku, Dereje Henok, Tamir Zemenu, Gebreweld Angesom
Department of Clinical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
PLoS One. 2021 Apr 27;16(4):e0250328. doi: 10.1371/journal.pone.0250328. eCollection 2021.
Data on the burden of dyslipidaemia among people with HIV undergoing antiretroviral therapy (ART) in sub-Saharan Africa are limited and little is known about the factors contributing for poor lipid profiles. The aim of this study was to determine the prevalence of dyslipidaemia and factors associated with lipid levels among HIV-infected patients receiving first-line combination ART in North Shewa, Ethiopia.
A cross-sectional study was conducted between April and December 2018 among 392 HIV-infected adults receiving first-line ART for at least six months at the ART clinic of Mehal Meda Hospital in North Shewa, Ethiopia. Blood samples were collected for determination of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), and CD4 counts. Logistic regression analysis was used to determine factors associated with lipid abnormalities.
The prevalence of dyslipidaemia was 59.9% (95% CI 55.0-64.7%). High TC, high TG, low HDL-c, and high LDL-c were obtained in 47.3%, 30.9%, 19.4% and 29.6%, respectively. Fifty-four participants (13.8%) had high ratio of TC/HDL-c (TC/HDL-c ratio ≥ 5). Older age was independently associated with high TC (AOR = 2.51, 95% CI 1.64-3.84), high TG (AOR = 2.95, 95% CI 1.85-4.71), low HDL-c (AOR = 2.02, 95% CI 1.17-3.50), and high LDL-c (AOR = 3.37, 95% CI 2.08-5.47). Living in an urban area (AOR = 2.61, 95% CI 1.16-6.14) and smoking (AOR = 3.61, 95% CI 1.06-12.34) were associated with low HDL-c. Participants with longer duration of ART use were more likely to have high TG (AOR = 1.86, 95% CI: 1.13-3.07), low HDL-c (AOR = 3.47, 95% CI: 1.75-6.80), and high LDL-c (AOR = 2.20, 95% CI 1.30-3.71). High BMI was independently associated with higher TC (AOR = 2.43, 95% CI 1.19-4.97), high TG (AOR = 4.17, 95% CI 2.01-8.67) and high LDL-c (AOR = 6.53, 95% CI 3.05-13.98).
We found a high prevalence of dyslipidaemia among HIV-infected patients receiving first-line ART in North Shewa, Ethiopia. There is a need for monitoring of blood lipid levels in patients with HIV on long term first-line ART with a special attention to be focused on older age, urban residents, longer duration of ART use, high BMI and smokers.
撒哈拉以南非洲地区接受抗逆转录病毒疗法（ART）的艾滋病毒感染者血脂异常负担的数据有限，且对导致血脂异常的因素知之甚少。本研究旨在确定埃塞俄比亚北谢瓦接受一线联合抗逆转录病毒治疗的艾滋病毒感染患者血脂异常的患病率以及与血脂水平相关的因素。
2018年4月至12月，在埃塞俄比亚北谢瓦梅哈尔梅达医院抗逆转录病毒治疗门诊对392名接受一线抗逆转录病毒治疗至少6个月的艾滋病毒感染成年人进行了横断面研究。采集血样以测定总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-c）、低密度脂蛋白胆固醇（LDL-c）和CD4计数。采用逻辑回归分析确定与血脂异常相关的因素。
血脂异常的患病率为59.9%（95%可信区间55.0 - 64.7%）。高总胆固醇、高甘油三酯、低高密度脂蛋白胆固醇和高低密度脂蛋白胆固醇的患病率分别为47.3%、30.9%、19.4%和29.6%。54名参与者（13.8%）的总胆固醇/高密度脂蛋白胆固醇比值较高（总胆固醇/高密度脂蛋白胆固醇比值≥5）。年龄较大与高总胆固醇（调整后比值比[AOR]=2.51，95%可信区间1.64 - 3.84）、高甘油三酯（AOR = 2.95，95%可信区间1.85 - 4.71）、低高密度脂蛋白胆固醇（AOR = 2.02，95%可信区间1.17 - 3.50）和高低密度脂蛋白胆固醇（AOR = 3.37，95%可信区间2.08 - 5.47）独立相关。居住在城市地区（AOR = 2.61，95%可信区间1.16 - 6.14）和吸烟（AOR = 3.61，95%可信区间1.06 - 12.34）与低高密度脂蛋白胆固醇相关。抗逆转录病毒治疗使用时间较长的参与者更有可能出现高甘油三酯（AOR = 1.86，95%可信区间：1.13 - 3.07）、低高密度脂蛋白胆固醇（AOR = 3.47，95%可信区间：1.75 - 6.80）和高低密度脂蛋白胆固醇（AOR = 2.20，95%可信区间1.30 - 3.71）。高体重指数与较高的总胆固醇（AOR = 2.43，95%可信区间1.19 - 4.97）、高甘油三酯（AOR = 4.17，95%可信区间2.01 - 8.67）和高低密度脂蛋白胆固醇（AOR = 6.53，95%可信区间3.05 - 13.98）独立相关。
我们发现埃塞俄比亚北谢瓦接受一线抗逆转录病毒治疗的艾滋病毒感染患者中血脂异常的患病率很高。对于长期接受一线抗逆转录病毒治疗的艾滋病毒患者，需要监测血脂水平，尤其要关注年龄较大者、城市居民、抗逆转录病毒治疗使用时间较长者、高体重指数者和吸烟者。
