Lipid Abnormalities among Libyan HIV-Infected Patients Receiving Antiretroviral (ARV) Drugs and ARV Naïve Patients

Introduction: Majority of untreated or Anti-Retroviral (ARV) treated HIV subjects may experience a lot of metabolic alterations including dyslipidemia, lipodystrophy and insulin resistance.

Aim: Due to the shortage of research data related to HIV infection. We conducted this study to assess the lipid profile in HIV infected subjects and to find a correlation between liver function enzymes and other biomarkers and serum lipid alterations among Libyan HIV subjects.

Materials and Methods: Case control study included 121 Libyan HIV-1 positive subjects (101 subjects were on First-line ARV treatment regimens and 21 untreated "Naïve") from Benghazi Medical Center (BMC) and Benghazi center for infectious diseases and immunology (BCIDI) during 2018-2019 to evaluate lipid profile and other biochemical parameters. Control group included 70 age-matched HIV negative individuals. The age range of the study participants was 20-45 years.

Results: The means of CD4 count in the ARV treated HIV subjects were significantly (P <0.014) lower compared CD4 count of untreated HIV group. The mean total cholesterol (TC) level of ARV treated HIV subjects (174 ± 42 mg/dl) was significantly (P<0.012) increased compared to untreated HIV subjects (149 ± 31mg/dl). In accordance, LDL-C levels showed a significant (P <0.014) increase in the ARV treated HIV subjects compared to the untreated HIV subjects. On the other hand, mean HDL-C showed no significant alteration in the ARV treated HIV subjects compared to untreated HIV subjects.

Conclusion: In ARV-treated HIV patients showed higher TC and LDL-C suggesting a role of these drugs upon lipid metabolism.

The mechanism by which HIV drugs affect lipid profile need to be fully understood by further research.

Unaltered HDL-C and LDL/HDL atherogenic risk ratio indicate reduced risk for developing cardiovascular disease among HIV subjects.