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P1.56 Predictors of cardiovascular risk and atherogenic indices among adult hiv seropositive patients on highly active antiretrovirals in western nigeria: a case-control study
  1. Usman Saheed Opeyemi,
  2. Agboola Ganiyu
  1. Department of Clinical Laboratory Services, Equitable Health Access Initiative, Lagos, Nigeria

Abstract

Introduction Cardiovascular risk factors place HIV-infected patients at increased risk for cardiovascular diseases (CVDs) due to complex interactions between traditional CVD risk factors, antiretroviral therapy (ART) and HIV infection itself. The report of the 2012 National Reproductive Health Survey Plus indicated that the prevalence of HIV/AIDS in Nigeria is about 3.4% while Ondo State has a prevalence of 4.3%. This study was therefore designed to evaluate the CD4+ T-cell count, atherogenic indices and risk score of adult HIV seropositives on Highly Active Antiretroviral Therapy (HAART), those not yet started on HAART and HIV seronegative control subjects. Hypothesis tested was the effect of the various drugs on the indices determining the risk level.

Methods Serum levels of CD4+ cell count of adult HIV seropositive subjects on HAART, HAART naïve subjects and seronegative controls were determined using flow cytometry while their atherogenic indices and Framingham risk score were determined from enzymatic spectrophotometrically determined lipids and lipoproteins. Ethical approval was obtained from the Ondo State Ministry of Health Research Ethics Committee, Akure, Nigeria. All data were expressed as Mean ± Standard Deviation and analysed with Analysis of Variance (ANOVA) while multiple comparisons were done using Post Hoc Bonferonni test.

Results The average duration (in months) of the use of HAART in the group 1 subjects is 25.63±19.99 while the average duration (in months) of cotrimoxazole use for subjects in group 2 is 7.10±4.89. There was a significant mean increased weight in the control subjects as compared with that of the other two groups. The mean serum cardiac risk ratio (CRR), atherogenic index of plasma (AIP), atherogenic coefficient (AC) and Framingham Risk Score (FRS) were significantly increased in the HAART group as compared with those of the two other groups.

Conclusion HIV appears to have negatively altered the exogenous and endogenous synthesis and metabolism of lipids and lipoproteins in the liver, with ultimate effect on the atherogenic indices and risk score. This is worsened by antiretroviral therapy as the increased levels of these indices were mainly seen in the HAART group, constituting a major risk for cardiovascular diseases in these patients, thus increasing mortality rate.

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