Vijay V1, Indumati V2, Krishnaswamy D3, Rajeshwari4, Ramesh5, Shanthala D6, Shilpa A7
BACKGROUND
HIV patients receiving highly active Anti-Retroviral Therapy (HAART) usually suffer from side effects like hepatitis, neurological problems, abnormal fat distribution etc. Among these, the most physical, mental and cosmetically disturbing side effect is adipose tissue alterations (ATA), also called as lipodystrophy, which is abnormal fat deposition (Lipohypertrophy) and/or fat atrophy (Lipoatrophy).
AIM
Several studies have shown dyslipidemia in patients on HAART, but there are very few studies on the lipid profile changes in patients on ART with ATA. Hence a study was conducted to assess the serum lipid profile and transaminases activity in patients on ART with ATA and also to evaluate whether lipid profile parameters can predict ATA changes in HIV patients on HAART.
METHOD
Randomly selected HIV positive patients, who were attending ART centre, were included in the study. Twenty five of these patients in whom HAART was yet to be started were considered as Control group, 25 patients on HAART for more than 12 months but without ATA as ART group and 23 patients on HAART with ATA as ATA group. Lipid profile and serum transaminases in all the groups were assayed by standard methods.
RESULTS
Serum cholesterol and LDL were significantly increased in ART group and ATA group when compared to control group, but there was no significant difference in lipid profile parameters between ART group and ATA group. Serum AST and ALT levels were significantly increased (p<0.02) in ATA group when compared to ART group. Buffalo hump was seen only in females in our study. Lipoatrophy (facial and limbs) and central obesity was seen in males.
CONCLUSION
There was no significant change in lipid profile parameters in ATA group when compared with ART group. Hence lipid profile parameters are not good predictors of ATA changes in HIV patients on HAART. Significant increase in transaminase levels suggests increased hepatotoxity in ATA patients due to HAART drugs. There is a need for further evaluation on the role of hormones, environmental or genetic factors in different clinical presentations of ATA in male and female patients.
