Dyslipidemia among adult people living with HIV on dolutegravir - based antiretroviral therapy at a private tertiary hospital in Kampala, Uganda: burden and determinants.
Dyslipidemia among adult people living with HIV on dolutegravir - based antiretroviral therapy at a private tertiary hospital in Kampala, Uganda: burden and determinants.
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DOI：
10.1186/s12879-023-08892-8
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发表时间：
2024-01-05
影响因子：
3.7
通讯作者：
Castelnuovo, Barbara
中科院分区：
文献类型：
--
作者：
Kigongo, Vianney John;Nankabirwa, Joaniter I.;Kitutu, Freddy Eric;Ssenyonga, Ronald;Mutebi, Ronald Kasoma;Kazibwe, Andrew;Kiguba, Ronald;Kambugu, Andrew D.;Castelnuovo, Barbara
关键词：
了解成人HIV感染者中的血脂异常及其相关因素对基于多洛替格列韦(DTG)的抗逆转录病毒疗法(ART)的负担至关重要，这对于在我们的环境下提供临床指导和降低风险策略至关重要。2022年7月至8月，我们在蒙戈医院对成年艾滋病毒携带者进行了一项基于DTG的横断面研究，蒙戈医院是乌干达教会拥有的一家私立非营利性传教医院。血脂异常的定义为：总胆固醇(TC) ≥ 5.2mmo1/L或高密度脂蛋白( <)；男性 1mmo1/L；女性 1.3mmo1/L；或甘油三酯 ≥ 1.7mmo1/L，低密度脂蛋白 ≥ 3.4mmo1/L。收集社会人口学信息、临床资料和行为特征。还测量了空腹血脂和空腹血糖水平。由于血脂异常的患病率超过10%，使用具有对数链接的泊松家族的广义线性模型回归(修正的泊松)进行双变量和多变量分析，并使用稳健的标准误差。报告调整后的患病率(PR)及其95%可信区间(CI)。P值小于0.05被认为具有统计学意义。共有341名参与者参加了调查。血脂异常患病率为78.0%(95%可信区间：73.3~82.1)。其次是高甘油三酯(20.2%，95%CI：16.3~24.9)、高TC(12.0%，95%CI：9.0~15.9)和高低密度脂蛋白(6.5%，95%CI：4.3~9.6)。女性(APR：1.55，95%CI：1.32~1.84，p <； 0.001)和既往使用过以蛋白酶抑制剂(PI)为基础的ART方案(APR：1.26，95%CI：1.04~1.53，p = 0.018)与血脂异常显著相关。我们证明，血脂异常的患病率非常高，因为它存在于超过四分之三的研究参与者中。女性和既往使用以PI为基础的抗逆转录病毒治疗方案与血脂异常显著相关。应将血脂异常的处理纳入HIV治疗方案，我们建议进一步探讨抗逆转录病毒治疗患者中血脂异常与DTG之间的时间关系(如果有)。网上版载有补充材料，可在10.1186/s12879-023-08892-8查阅。
Understanding the burden of dyslipidemia and its associated factors among adult people living with HIV on dolutegravir (DTG) based anti-retroviral therapy (ART) is critical to provide clinical guidance and risk reduction strategies in our setting. We conducted a cross-sectional study on adult people living with HIV on DTG based ART between July and August 2022 at Mengo Hospital, a private not for profit missionary hospital owned by the Church of Uganda. Dyslipidemia was defined as: Total cholesterol (TC) ≥ 5.2 mmol/l, or high-density lipoprotein (HDL) < 1 mmol/l for men and < 1.3 mmol/l for women, or triglycerides (TG) ≥ 1.7 mmol/l, and low-density lipoprotein (LDL) ≥ 3.4 mmol/l. A participant was considered to have dyslipidemia if they had any of the lipid profile parameters in the above ranges. Socio-demographic information, clinical data and behavioral characteristics were collected. Fasting lipid profile and fasting blood glucose levels were also measured. Bivariate and multivariate analyses were done using a generalized linear model regression of the Poisson family with a log link (modified Poisson) using robust standard errors since the prevalence of dyslipidemia was more than 10%. Adjusted prevalence ratios (PR) were reported with their 95% confidence intervals (CI). A p-value of less than 0.05 was considered statistically significant. A total of 341 participants were included. The prevalence of dyslipidemia was 78.0%, (95%CI:73.3–82.1). The highest prevalence was for low HDL (72.1%, 95%CI 67.1–76.7) followed by high TG (20.2%, 95%CI: 16.3–24.9), high TC (12.0%, 95%CI: 9.0–15.9) and high LDL (6.5%, 95%CI: 4.3–9.6). Female sex (aPR:1.55, 95%CI: 1.32–1.84, p < 0.001) and previous use of protease inhibitor (PI) based ART regimen (aPR:1.26, 95%CI: 1.04–1.53, p = 0.018) were significantly associated with dyslipidemia. We demonstrate that the prevalence of dyslipidemia is very high as it was present in more than three quarters of the study participants. Female sex and previous use of PI based ART regimen were significantly associated with dyslipidemia. Management of dyslipidemia should be integrated in the HIV treatment package and we recommend further inquiry into the temporal relationship between dyslipidemia and DTG among ART patients, if any. The online version contains supplementary material available at 10.1186/s12879-023-08892-8.
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DOI：
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