Table 2.
The prevalence and type of dyslipidemia associated with HIV medications in some African countries.
| Reference | Country | Type of study | Study population | Dyslipidemia | Prevalence | Main conclusion |
|---|---|---|---|---|---|---|
| Dave et al80 | South Africa - Cape Town | A cross- sectional study | 406 adult ART- naïve and 551 adult HIV participants receiving NNRTI*- based or PI**- based ART | High TG, TC, LDL-c and low HDL-c | 90.0% and 85%, respectively | Dyslipidemia likely to occur with ART more than with ART-naïve |
| Julius et al81 | South Africa - Johannesburg | A cross- sectional study | 304 HIV adult patients on HAART for more than 1 year | High TG, TC, LDL-c and low HDL-c | Hypertriglyceridemia (>2.25 mmol (mL) in 15.8%, hypercholesterolemia (TC >5.00 mmol/mL) in 32.2%, low HDL-c (<1.20 mmol/mL) in 45.7% and elevated LDL-c (>4.10 mmol/mL) in 9.5% | ART administration is associated with dyslipidemia |
| Manuthu et al40 | Kenya | A cross- sectional comparative group study | 295 HIV adult patients; 134 (45%) were on HAART, 82% of whom were on stavudine, lamivudine and either nevirapine or efavirenz | High TG, TC, LDL-c and low HDL-c | Overall prevalence of dyslipidemia was 63.1% and dysglycemia was 20.7%. High TC occurred in 39.2% of HAART and 10.0% HAART naïve patients (p<0.0001), whereas high LDL-c occurred in 40.8% and 11.2%, respectively (p<0.0001, OR 5.43, 95% CI 2.973–9.917). HDL levels were low in 14.6% and 51.3% among HAART and HAART-naïve patients, respectively (p<0.0001, OR 0.16, 95% CI 0.091–0.29), while high TG occurred in 25.6% and 22.5%, respectively (p=0.541 OR 1.184 95% CI 0.688–2.037) | HAART was associated with high total cholesterol and LDL-c and high triglyceride levels. However, HAART was not associated with low HDL-c and had no effect on dysglycemia |
| Lesi et al82 | Nigeria - Lagos | A prospective cross-sectional study | 113 adult HIV patients on HAART therapy for 6–42 months | High TG, TC, LDL-c and low HDL-c | Fatty liver prevalence was 13.3%. High cholesterol, LDL-c and TG were seen in 28%, 24% and 35%, respectively | Hepatic steatosis was strongly associated with hepatomegaly and hyperlipidemia in subjects on long-term HAART |
| Salami et al83 | Nigeria - Ilorin | 127 HIV adult patients; 94 (29%) on PI and 233 (71%) on NNRTI regular treatment for at least 3 months | Low HDL, high triglyceride, cholesterol and LDL-c | The pretreatment metabolic changes in both groups (PI vs. NNRTI) were low HDL-c; 29 (31%) vs. 77 (33%), followed by hypertriglyceridemia; 16 (17%) vs. 38 (16%) and hypercholesterolemia; 6 (6%) vs. 10 (4%). After exposure to two different HAART regimens, hypertriglyceridemia and hypercholesterolemia became more prevalent especially with PI-based therapy than NNRTI; 74 (79%) vs. 108 (54%) and 58 (51%) vs. 72 (31%) | HARRT treatment, especially PI, worsened dyslipidemia (3 times) | |
| Armstrong et al77 | Tanzania | A cross- sectional study | 12,513 ART-naïve, non-fasting HIV adult patients | High TG, TC, LDL-c and low HDL-c | Low HDL-c was prevalent in 67% and increased TG in 28% | Dyslipidemia was associated with low CD4 counts (p<0.001) |
| Muronya et al84 | Malawi | A cross- sectional study | 174 HIV adult patients on long- term (>1 year) ART | High cholesterol | High TC levels (31.0%), raised blood pressure (45.9%), increased waist- hip ratio (45.4%) | Cardiovascular risk factors were common among long-term ART patients in Malawi |
| Feleke et al72 | Ethiopia Addis Ababa | A cross- sectional study | 356 HIV adult patients on HAART for 1 year or more. 209 (59.7%) patients were on stavudine- based ART therapy and 135 (41.3%) were on zidovudine-based ART therapy | High TG, TC, LDL-c and low HDL-c | Prevalence of hyperlipidemia was 56.9%, prevalence of hypercholesterolemia was 38.2%, prevalence of high LDL-c 54.2%, prevalence of hypertriglyceridemia was 15.2%, prevalence of fasting hyperglycemia was 17.8% | Lipodystrophies occurred in majority of patients on ART treatment for longer than 1 year; hyperlipidemia and hyperglycemia were also seen commonly in Ethiopian HIV patients on HAART |
| Bekolo et al78 | Cameroon | A cross- sectional study | 114 HIV-infected persons aged 15 years or more and receiving first-line ART for at least 6 months | High TG, TC, LDL-c and low HDL-c | Prevalence of hyperlipidemia was 70.2%, prevalence of hypercholesterolemia was 29.8%, prevalence of high LDL-c was 30%, prevalence of hypertriglyceridemia was 51.8% | A high prevalence of dyslipidemia in HIV patients receiving first-line ART was found |
Abbreviations: ART, antiretroviral therapy; CI, confidence interval; HDL-c, high-density lipoprotein cholesterol; HIV, human immunodeficiency virus; LDL-c, low-density lipoprotein cholesterol; NNRTI, non-nucleoside reverse transcriptase inhibitor; OR, odds ratio; PI, protease inhibitor; TC, total cholesterol; TG, triglyceride.