Comparison of Lipid Profile in Two Different Groups of AIDS Patients on Different ART Regimens

Objective: Dyslipidemia is an adverse metabolic effect of Anti Retroviral Therapy (ART). Among different categories of ART drugs, there are different mechanism for changing lipid metabolism in the body and the effects of Protease Inhibitors (PIs) seems to be more than the others. In this study we compare two groups of AIDS patients on two different HAART regimens regarding their lipid profile. Materials & Methods: From October 2005 to September 2008 two groups of AIDS patients referring to HIV clinic at Emam Khomini Hospital in Tehran, consist of 47 patients who received Zidovudine, Lamivudine and Nelfinavir (group 1) and 47 patients who received Zidovudine, Lamivudine and Efavirenz (group 2) compared with each other considering fasting serum level of cholesterol, triglyceride (TG), low density lipoprotein (LDL) and high density lipoprotein (HDL). Patients in two groups were matched according to age, gender, body mass index, HCV co infection and behavioral habits (i.e. alcohol usage and exercise) that could influence the lipid profile. Gathered data from were analyzed by SPSS version 13 and result were compared using T test and chi square test. Statistical significance was accepted at a level of p<0.05. Results: Of 94 cases evaluated in two groups, with 40 male and 7 female in each group, the mean of age was 36.3 years old. The plasma levels of HDL were lower and TG were higher in group 1 compared with the other group (P<0.05). Cholesterol and LDL plasma levels were both higher in group 1 but there were not statistically significant differences for cholesterol and LDL levels between two groups (P>0.05). Considering upper limit of normal range of plasma level of measure lipid profiles, only TG plasma level elevation above critical level (>200) was statistically significant different between two groups (P=0.02). Triglyceride rose above critical level in 11 cases in group 1 compared with 2 cases in group 2. Conclusion: According to our study, HDL and TG levels are highly related to type of drug (PI vs NNRTI) that used for treatment of AIDS patients. More patients had higher TG plasma level in regimen included Nelfinavir compared with Efavirenz.

Dyslipidemia, Protease Inhibitor, NNRTI