title: Fasting blood glucose and insulin sensitivity are unaffected by HAART duration in Cameroonians receiving first-line antiretroviral treatment.
abstract: OBJECTIVE
  This study assessed the relationship between highly active antiretroviral therapy (HAART) duration and cardiometabolic disorders in HIV-infected Cameroonians.
  
  
  METHODS
  HIV-infected Cameroonians aged 21 years or above were cross-sectionally recruited at the Yaoundé Central Hospital, a certified HIV care centre, and their anthropometry, body composition (impedancemetry), fasting blood glucose (FBG) and lipid levels, and insulin sensitivity (IS; short insulin tolerance test) were measured.
  
  
  RESULTS
  A total of 143 participants with various durations of HAART [treatment-naïve (n=28), 1-13 months (n=44), 14-33 months (n=35) and 34-86 months (n=36)] were recruited. They were mostly women (72%), and had a mean age of 39.5 (SD: 9.8) years. Half (52%) were using a stavudine-containing regimen. There was a significant trend towards a positive change in body mass index and waist-to-hip ratio with increasing duration of HAART (all P=0.02). Systolic (P=0.04) and diastolic (P=0.03) blood pressure, total cholesterol (P=0.01), prevalence of hypertension (P=0.04) and hypercholesterolaemia (P=0.007) were also significantly increased with HAART duration, whereas triglycerides, FBG and IS were unaffected. Clustering of metabolic disorders increased (P=0.02 for ≥1 component of the metabolic syndrome and P=0.09 for ≥2 components) with HAART duration.
  
  
  CONCLUSIONS
  HAART duration is associated with obesity, fat distribution, blood pressure and cholesterol levels in HIV-infected Cameroonians, but does not appear to significantly affect glucose metabolism.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
authors.forename: L G
authors.initials: LG
authors.lastname: Ekali
authors.forename: L K
authors.initials: LK
authors.lastname: Johnstone
authors.forename: J B
authors.initials: JB
authors.lastname: Echouffo-Tcheugui
authors.forename: C
authors.initials: C
authors.lastname: Kouanfack
authors.forename: M Y
authors.initials: MY
authors.lastname: Dehayem
authors.forename: L
authors.initials: L
authors.lastname: Fezeu
authors.forename: B
authors.initials: B
authors.lastname: Nouthe
authors.forename: L
authors.initials: L
authors.lastname: Hayes
authors.forename: N C
authors.initials: NC
authors.lastname: Unwin
authors.forename: E
authors.initials: E
authors.lastname: Sobngwi
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D050218:Body Fat Distribution; D002163:Cameroon; D002318:Cardiovascular Diseases / Q000097:blood* / Q000188:drug therapy; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy; D005215:Fasting; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000378:metabolism*; D006297:Health Services Accessibility; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008297:Male; D018119:Stavudine / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D019380:Anti-HIV Agents; D001786:Blood Glucose; D008055:Lipids; D018119:Stavudine