Lipid Profile and Cardiovascular Risk in HIV/AIDS Patients on Antiretroviral Therapy: Impact of Intervention on the Modifiable Risk Factors
Pablo Rodrigues Costa-Alves
Ricardo A T Castilho Center of Studies, Teresópolis Medical Association, R. Wilhelm Cristian Kleme, 680 - Ermitage, Teresópolis/RJ, Zip-Code: 25975-550, Brazil
Erika Cesar de Oliveira Naliato *
Ricardo A T Castilho Center of Studies, Teresópolis Medical Association, R. Wilhelm Cristian Kleme, 680 - Ermitage, Teresópolis/RJ, Zip-Code: 25975-550, Brazil
Filipe Augusto Carvalho de Paula
Ricardo A T Castilho Center of Studies, Teresópolis Medical Association, R. Wilhelm Cristian Kleme, 680 - Ermitage, Teresópolis/RJ, Zip-Code: 25975-550, Brazil
Margarete Domingues Ribeiro
Serra dos Orgãos University Center (UNIFESO), Av. Alberto Torres 111 – Alto, Teresópolis/RJ, Zip-Code: 25964-004, Brazil
Maria de Fatima Silva Moreira Jorge
Serra dos Orgãos University Center (UNIFESO), Av. Alberto Torres 111 – Alto, Teresópolis/RJ, Zip-Code: 25964-004, Brazil
*Author to whom correspondence should be addressed.
Abstract
Aims: To evaluate the lipid profile and cardiovascular (CV) global risk of Brazilian HIV/AIDS patients before and after highly active antiretroviral therapy (HAART), and to study the impact of the intervention on the modifiable risk factors on CV risk.
Study Design: A prospective intervention study.
Place and Duration of Study: HIV/AIDS clinics of Teresópolis (RJ) - Brazil, between 2010 and 2012.
Methodology: This study included 129 adult HIV-positive patients; HAART had been prescribed for a minimum period of one year. Patients were evaluated at 3 different stages: (1) Stage A: previously to HAART, (2) Stage B: after receiving HAART for 1 year, and (3) Stage C: 6 months after the intervention on the modifiable risk factors (treatment of dyslipidaemia, Diabetes Mellitus and arterial hypertension, encouragement of smoking cessation and institution of healthy dietary habits).
Results: A significant elevation of serum levels of cholesterol (186.1 ± 53.6 to 205.4 ± 49.5 mg/dL, P = .01) and a reduction of HDL-C (44.7 ± 6.3 to 42.3 ± 7.3 mg/dL, P = .02) was found after the introduction of HAART. Conversely, a decrease in total cholesterol levels was observed after the intervention on CV risk factors (205.4 ± 49.5 to 188.0 ± 62.8 mg/dL, P = .03). The CV risk was significantly reduced after the clinical intervention on modifiable risk factors (P = .02), based on the appropriate Brazilian guidelines.
Conclusion: The study is in accordance with the literature regarding the alterations of lipid profile and CV risk secondary to HAART. Despite its limitations, the present study supports the importance of screening and intervening on the modifiable risk factors to improve CV risk in the Brazilian HIV/AIDS population.
Keywords: HIV, AIDS, cardiovascular risk, HAART