The lipid profile of HIV-infected patients receiving antiretroviral therapy in a rural Cameroonian population

BACKGROUND: Long term use of antiretroviral therapy (ART) in persons living with human immunodeficiency virus (PLWHIV) is associated with disturbances in blood lipids which should be monitored. More data on such disturbances are needed in Cameroon to persuade the country program to institute their routine monitoring. We then sought to determine the prevalence and timing of dyslipidaemia in PLWHIV and receiving ART in a predominantly rural Cameroonian setting. METHODS: A cross-sectional study conducted between August and October 2012 in HIV-infected persons aged 15 years or more and receiving first-line ART for at least six months at The Nkongsamba Regional Hospital in Cameroon. Lipid assays were carried out by enzymatic-linked colorimetric methods. A multiple logistic regression model was used to assess for factors related to dyslipidaemia. RESULTS: Included were 114 participants of whom 83 (72.8%) were females. Their median age was 43 years (IQR: 36–51) and their median CD4 count was 436 cells/μl (IQR: 275–585) after a median duration on ART of 36 months (IQR: 12–60). The prevalence of dyslipidaemia was 70.2%. Hypercholesterolaemia was observed in 34 (29.8%) patients. One-third of them had a high LDL-cholesterol level (LDL-c ≥ 130 mg/dl). Hypertriglyceridaemia (TG ≥ 150 mg/dl) was present in 59 (51.8%) cases. The proportion of patients with a low HDL-cholesterol (HDL-c < 40 mg/dl) was 18.4% while those with a ratio of TC/HDL-c ≥ 5 were about 16.7%. A duration of 2–4 years on ART (adjusted Odd Ratio, aOR = 5.22, 95% CI: 1.43-19.06, p = 0.01), current smokers (aOR = 15.94, 95% CI: 1.13-225.61, p = 0.04) and a concurrent metabolic disease (aOR = 12.54, 95% CI: 1.02-153.86, p = 0.48) were independently associated with pro-atherogenic LDL-c values. Alcohol users had a more friendly LDL-c profile (aOR = 0.24, 95% CI: 0.07-0.74, p = 0.01). CONCLUSION: The study has demonstrated a high prevalence of dyslipidaemia in HIV-patients receiving first-line ART in a predominantly rural setting of Cameroon. There is a need for the country HIV program to institute laboratory monitoring of blood lipids in patients over two years on first line ART with a focus on smokers.