Paradoxical Lipid Patterns and Elevated Atherogenic Risk in HIV Patients on Antiretroviral Therapy from the Rivers State University Teaching Hospital, Nigeria
Tarila Ngowari Aleruchi-Didia *
Department of Chemical Pathology, Faculty of Medical Laboratory Science, Rivers State University, Nkpolu-Oroworukwo, Port Harcourt, Rivers State, Nigeria.
Adline Erinma Ben-Chioma
Department of Clinical Chemistry, Faculty of Medical Laboratory Science, Rivers State University, Port Harcourt, Nigeria.
Chinwebudu M. Melford
Department of Medical Technology, College of Allied Medical Sciences, Cebu Doctors’ University, Mandaue City, Cebu, Philippines.
*Author to whom correspondence should be addressed.
Abstract
Background: Human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) are associated with metabolic disturbances, including dyslipidaemia and increased cardiovascular risk.
Aim: This study evaluated lipid profile alterations and atherogenic cardiovascular risk among HIV-positive patients receiving ART.
Methods: A hospital-based cross-sectional study was conducted among 150 participants (90 HIV-positive on ART and 60 HIV-negative controls) at Rivers State University Teaching Hospital, Nigeria. Fasting lipid parameters were measured, and atherogenic indices, Castelli’s Risk Index I (CRI-I), Castelli’s Risk Index II (CRI-II), Atherogenic Index of Plasma (AIP), and Atherogenic Coefficient (AC)—were calculated.
Results: HIV-positive participants had significantly higher total cholesterol (6.42 ± 0.68 vs 4.98 ± 0.55 mmol/L), triglycerides (2.36 ± 0.41 vs 1.52 ± 0.29 mmol/L), LDL-C (3.92 ± 0.64 vs 3.05 ± 0.58 mmol/L), and non-HDL cholesterol (5.47 ± 0.72 vs 3.64 ± 0.60 mmol/L), alongside significantly lower HDL-C levels (0.95 ± 0.21 vs 1.34 ± 0.25 mmol/L) (p < 0.001). Atherogenic indices were markedly elevated in HIV-positive individuals: CRI-I (7.02 ± 1.84 vs 3.82 ± 0.91), CRI-II (4.36 ± 1.21 vs 2.21 ± 0.74), AIP (0.42 ± 0.12 vs 0.08 ± 0.10), and AC (6.02 ± 1.75 vs 2.82 ± 0.88) (p < 0.001).
Conclusion: HIV-positive patients on ART exhibit a classical atherogenic lipid profile characterized by elevated LDL-C and reduced HDL-C, alongside significantly increased atherogenic indices. These findings highlight the combined impact of HIV infection and ART on cardiovascular risk and support the integration of atherogenic indices into routine HIV care.
Keywords: HIV, dyslipidaemia, atherogenic indices, cardiovascular risk, antiretroviral therapy, Nigeria