ABSTRACT

The impact of Human Immunodeficiency Virus infection (HIV) and Antiretroviral 'therapy (ART) on cardiovascular and metabolic events were evaluated in 154 HIV patients, aged 15-55 years, seen at the HIV laboratory of the Abia State University Teaching Hospital, Aba. They were enrolled in the study after informed consent was obtained and stratified into four groups. Groups I and 2 were made up of 25 male and 62 female patients respectively not on antiretroviral therapy (NON-ART). Groups 3 and 4 were 26 male and 41 female patients respectively on combined Lamivudine l5Oiiig, Zidovudine 300mg and Nevirapine 200mg therapy (ART) for over 12 months. 50 J-HV negative subjects (18-50 years), 20 males and 30 females, served as controls. The study was categorized under Cardiovascular, metabolic, immunologic, renal function and hematological parameters. Blood samples were collected and analyzed. Total cholesterol and Low density lipoprotein values were significantly reduced in NON-ART patients compared to ART patients and control subjects (P<0.001). Triacyiglyceride (TG) high sensitivity cardiovascular Reactive Protein (hsCRP) levels were elevated in ART and NONART patients compared to control subjects (P<0.001). Serum High Density Lipid Cholesterol levels of ART and NON-ART patients were not significantly different compared to control subjects. Serum glucose levels were significantly higher in ART and NON-ART patients respectively compared to control subjects (P<0.05). Serum insulin level was higher in ART patients compared to NON-ART and control subjects. Sodium level of NON-ART patients was significantly lower than ART patients and control subjects respectively. Potassium levels of ART and NON-ART patients were not different compared to control subjects (P>0.05). Chloride level of NON-ART patients was significantly lower than ART patients. Serum Alanine aminotransferase and Aspartate aminotransferase levels of NONART were significantly higher compared to ART patients and control subjects respectively (P<0.05). CD4+ count was significantly reduced in ART and NON-ART patients compared to control subjects xx  (P<O.00l). CD3+ cell count value was higher in control subjects compared to ART and NON-ART patients (P>O.05). Serum creatinine levels of ART and NON-ART patients were higher compared to control subjects (P>O.05) while creatinine clearance values of ART' and NON-ART patients were lower compared to control subjects (P<O.05). There were no significant difference in total WBC count values of ART and NON-ART compared to control subject. Platelets count, Hemoglobin, Packed Cell Volume and Neutrophil values of NON-ART patients were significantly lower compared to control subjects and ART patients. Lymphocyte was significantly higher in NON-ART patients as compared to ART patients and control subjects respectively while monocyte count was significantly higher in ART and NON-ART patients respectively compared to control subjects. This study showed that lipid changes in ART patients may represent a reversal to the patient's normal values rather than drug toxicity. Hyperinsulinaemia may be due to drug effect while elevated TG, hsCRP and haematological changes arc due to I IIV adverse effect. The normal creatinine and creatinine clearance values are indicative of non-renal pathology and non-nephrotoxicity of HIV drugs, while inflammation is a key player in atherogenesis with hsCRP as an emerging marker of cardiovascular events.