title: Cardiometabolic risk factors among HIV patients on antiretroviral therapy.
abstract: BACKGROUND
  HIV and combination antiretroviral therapy (cART) may increase cardiovascular disease (CVD) risk. We assessed the early effects of cART on CVD risk markers in a population with presumed low CVD risk.
  
  
  METHODS
  Adult patients (n=118) in Lusaka, Zambia were recruited at the time of initiation of cART for HIV/AIDS. Cardiometabolic risk factors were measured before and 90 days after starting cART. Participants were grouped according to cART regimens: Zidovudine + Lamivudine + Nevirapine (n=58); Stavudine + Lamivudine + Nevirapine (n=43); and 'other' (Zidovudine + Lamivudine + Efavirenz, Stavudine + Lamivudine + Efavirenz, Tenofovir + Emtricitabine + Efavirenz or Tenofovir + Emtricitabine + Nevirapine, n=17). ANOVA was used to test whether changes in cardiometabolic risk markers varied by cART regimen.
  
  
  RESULTS
  From baseline to 90 days after initiation of cART, the prevalence of low levels of high-density lipoprotein cholesterol (<1.04 mmol/L for men and <1.30 mmol/L for women) significantly decreased (78.8% vs. 34.8%, P<0.001) while elevated total cholesterol (TC ≥5.18 mmol/L, 5.1% vs. 11.9%, P=0.03) and the homeostasis model assessment of insulin resistance ≥3.0 (1.7% vs. 17.0%, P<0.001) significantly increased. The prevalence of TC:HDL-c ratio ≥5.0 significantly decreased (44.9% vs. 6.8%, P<0.001). These changes in cardiometabolic risk markers were independent of the cART regimen.
  
  
  CONCLUSIONS
  Our results suggest that short-term cART is associated with a cardioprotective lipid profile in Zambia and a tendency towards insulin resistance regardless of the cART regimen.
authors.affiliation: Department of Medicine, Division of Epidemiology, Vanderbilt University, Nashville, TN 37203, USA.
authors.forename: James N
authors.initials: JN
authors.lastname: Kiage
authors.forename: Douglas C
authors.initials: DC
authors.lastname: Heimburger
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Nyirenda
authors.forename: Melissa F
authors.initials: MF
authors.lastname: Wellons
authors.forename: Shashwatee
authors.initials: S
authors.lastname: Bagchi
authors.forename: Benjamin H
authors.initials: BH
authors.lastname: Chi
authors.forename: John R
authors.initials: JR
authors.lastname: Koethe
authors.forename: Donna K
authors.initials: DK
authors.lastname: Arnett
authors.forename: Edmond K
authors.initials: EK
authors.lastname: Kabagambe
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000480:Alkynes; D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D048588:Benzoxazines / Q000494:pharmacology / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000097:blood / Q000517:prevention & control* / Q000821:virology; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003521:Cyclopropanes; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007333:Insulin Resistance; D019259:Lamivudine / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D019829:Nevirapine / Q000494:pharmacology / Q000627:therapeutic use; D063065:Organophosphonates / Q000494:pharmacology / Q000627:therapeutic use; D012307:Risk Factors; D018119:Stavudine / Q000494:pharmacology / Q000627:therapeutic use; D000068698:Tenofovir; D014280:Triglycerides / Q000097:blood; D015024:Zambia; D015215:Zidovudine / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D003521:Cyclopropanes; D063065:Organophosphonates; D014280:Triglycerides; D019259:Lamivudine; D015215:Zidovudine; D019829:Nevirapine; D000068698:Tenofovir; D018119:Stavudine; D000225:Adenine; C098320:efavirenz