Dyslipidemia in HIV Infected Children and Adolescents on Highly Active Antiretroviral Therapy in Abuja, Nigeria

Background: Compelling evidence exists on the usefulness of highly active antiretroviral therapy in the improvement of life of people living with HIV. There is however growing concern from its prolong exposure in children because of possible undesirable effects on the body lipid profile with its potential cardiovascular risks. We therefore conducted this study to evaluate the lipid profile of children and adolescents on highly active antiretroviral therapy overtime in our health institution for possible intervention.

Methods: A cross sectional hospital based study was conducted among 161 HIV-infected children and adolescents on highly active antiretroviral therapy in our health institution from February to May 2016 for the above objectives. Data collection was through questionnaire interview, and results of laboratory assay, while analysis was with SPSS version 21 software. P > 0.05 was set as statistically significant and confidence interval calculated at 95%.

Results: The mean age of the study participants was 10.13 ±4.5 years, with 10-14 years 72(44.7%) forming the majority of the study population. One hundred and three (64.0%) were males, their mean body mass index, systolic/ diastolic blood pressures, total cholesterol, total triglyceride, low density lipoprotein cholesterol, and high density lipoprotein cholesterol were 16.01±3.0 mg/m2, 93.50±9.9 mmHg/ 56.43±10.3 mmHg, 149.61±39.5 mg/dl, 119.95±12.1 mg/dl, 74.93±35.3 mg/dl, 55.04±19.7 mg/dl respectively. They were on highly active antiretroviral therapy for a mean duration of 7.91±3.2 years, with 139(86.3%) being on 1st line antiretroviral medications. Total cholesterol >170 mg/dl occurred in 45(27.9%) of the subjects, 30(18.6%) had high level of total triglyceride of >150 mg/dl, 20(12.4%) had low density lipoprotein cholesterol of >130 mg/dl, while high density lipoprotein cholesterol of <35 mg/dl occurred in 28(17.4%) of the subjects. Majorities of the study subjects with dyslipidemia were of grade1 and 2 elevations for total cholesterol, total triglyceride, and low density lipoprotein cholesterol. Risk factor for dyslipidemia include BMI [OR 2.158 (95% CI 1.014-4.59) p=0.044] using total cholesterol, and types of 1st line [OR 0.107 (95% CI 0.008-1.029) p-0.033], 2nd line HAART [OR 0.042 (95% CI 0.0007-1.38) p=0.006], and BMI [OR 0.316 (95% CI 0.112-0.88) p-0.023] using high density lipoprotein cholesterol.

Conclusion: Use of first and second line highly active antiretroviral therapy regimen, and high BMI were associated with raised lipid profile. These parameters are to be monitored periodically while on these medications for any rising trends.