Department of Biomedical Science, School of Medicine, Debre Markos University, Debre Markos, Ethiopia.
Department of Biochemistry, School of Medicine, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia.
Ann Med. 2023;55(2):2295435. doi: 10.1080/07853890.2023.2295435. Epub 2023 Dec 20.
Antiretroviral therapy-linked metabolic abnormalities have become a growing concern among people living with HIV. There is limited data regarding the effects of dolutegravir-based treatment on blood glucose levels and serum lipid profiles in people living with HIV in Ethiopia. Thus, this study aimed to assess blood glucose levels and serum lipid profiles among people living with HIV on dolutegravir-based versus efavirenz-based therapy.
An institutional-based comparative cross-sectional study was conducted from 30 June 2021 to 30 August 2021. A total of 128 participants (64 in the dolutegravir-based group and 64 in the efavirenz-based group) were enrolled in the study. The Chi-square, independent -test, Mann-Whitney -test, and logistic regression were used as appropriate statistical tests using SPSS Version 26.0 for this study. A -value of <0.05 was considered statistically significant.
The prevalence of hyperglycemia and dyslipidemia were 17.2% (11/64) and 79.7% (51/64) in the dolutegravir group, and 9.4% (6/64) and 75% (48/64) in the efavirenz group, respectively. The efavirenz group had significantly higher mean values of total cholesterol (190.73 ± 44.13 vs. 175.27 ± 37.67 mg/dl, = 0.035) and high-density lipoprotein (47.53 ± 14.25 vs. 40.92 ± 13.17 mg/dl, = 0.007) than the dolutegravir group. For a Kg/m increase in BMI and for each month's increase in the duration of HIV, the patients were 66% (AOR = 1.66, 95% CI: 1.13, 2.44), and 13% (AOR = 1.13, 95% CI: 1.03, 1.23) more likely to have hyperglycemia, respectively. In contrast, female patients were 3.04 times more likely to have dyslipidemia (AOR = 3.03, 95% CI: 1.14, 8.05) as compared to male patients, and with an increase in CD4 cell count of 1 cell/mm, the odds of dyslipidemia increased by 0.3% (AOR = 1.003, 95% CI: 1.001, 1.006).
Efavirenz-based therapy resulted in higher mean values of total cholesterol and high-density lipoprotein as compared with dolutegravir-based therapy. It is important to consider and evaluate high-density lipoprotein levels in HIV patients on dolutegravir-based therapy, and total cholesterol levels in people living with HIV on efavirenz-based therapy.
抗逆转录病毒治疗相关的代谢异常已成为 HIV 感染者日益关注的问题。在埃塞俄比亚，关于基于多替拉韦的治疗对 HIV 感染者血糖水平和血清脂质谱的影响的数据有限。因此，本研究旨在评估基于多替拉韦和依非韦伦的治疗对 HIV 感染者血糖水平和血清脂质谱的影响。
本研究为 2021 年 6 月 30 日至 8 月 30 日进行的机构间对比性横断面研究。共有 128 名参与者（64 名在多替拉韦组，64 名在依非韦伦组）纳入本研究。使用适当的统计检验方法，如卡方检验、独立样本 t 检验、Mann-Whitney U 检验和逻辑回归分析，使用 SPSS 版本 26.0 进行数据分析。P 值<0.05 被认为具有统计学意义。
多替拉韦组中，高血糖和血脂异常的患病率分别为 17.2%（11/64）和 79.7%（51/64），依非韦伦组分别为 9.4%（6/64）和 75%（48/64）。依非韦伦组的总胆固醇（190.73 ± 44.13 vs. 175.27 ± 37.67 mg/dl， = 0.035）和高密度脂蛋白（47.53 ± 14.25 vs. 40.92 ± 13.17 mg/dl， = 0.007）的平均值显著高于多替拉韦组。对于 BMI 每增加 1kg/m2 和 HIV 持续时间每月增加 1 个月，患者发生高血糖的可能性分别增加 66%（AOR = 1.66，95% CI：1.13，2.44）和 13%（AOR = 1.13，95% CI：1.03，1.23）。相比之下，与男性患者相比，女性患者发生血脂异常的可能性高出 3.04 倍（AOR = 3.03，95% CI：1.14，8.05），而 CD4 细胞计数每增加 1 个/mm，血脂异常的几率增加 0.3%（AOR = 1.003，95% CI：1.001，1.006）。
与多替拉韦组相比，依非韦伦组的总胆固醇和高密度脂蛋白平均值更高。在接受多替拉韦治疗的 HIV 患者中，有必要考虑和评估高密度脂蛋白水平，而在接受依非韦伦治疗的 HIV 感染者中，有必要考虑和评估总胆固醇水平。
