title: Dyslipidemia and fasting glucose impairment among HIV patients three years after the first antiretroviral regimen in a Brazilian AIDS outpatient clinic.
abstract: OBJECTIVE
  To evaluate the cumulative incidence of dyslipidemia and fasting glucose impairment three years after initiating the first antiretroviral (ART) regimen and the association with the type of ART regimen in an AIDS outpatient clinic in Brazil.
  
  
  METHODS
  Retrospective cohort of HIV-1 infected patients attending an outpatient HIV clinic in Vitoria, Brazil, between January/2010 and May/2011. Data, including blood pressure, dyslipidemia (high total cholesterol and low HDL-C), fasting glucose, and cardiovascular risk by Framingham Risk Score were abstracted from medical records from clinic visits six months prior and three years after starting ART. We assessed independent associated factors for dyslipidemia using multiple logistic regression.
  
  
  RESULTS
  Four hundred and ninety-eight patients on ART were studied. Median age was 45 years (interquartile range (IQR): 37-52), and median time since HIV diagnosis was 7.7 years (IQR: 3.8-10.0). The proportion of patients with dyslipidemia was 22.3% (95% CI: 18.6-25.9%) 36 months after ART initiation. Triglycerides levels >150mg/dL (55.2% vs. 25.4%, p=0.021) and high fasting glucose (5.8% vs. 2.3%, p=0.034) were diagnosed more frequently after ART use when compared to baseline values. Multiple logistic regression analysis has shown dyslipidemia to be associated with lopinavir/r use [OR=1.74 (95% CI: 1.12-2.86)].
  
  
  CONCLUSIONS
  These data show high chance of dyslipidemia after initiation of ART. Long-term follow-up will help identify the impact of ART on cardiovascular risk.
authors.affiliation: Department of Internal Medicine, Escola de Ciências da Santa Casa de Vitoria (EMESCAM), Vitória, ES, Brazil. lauro.neto@emescam.br
authors.forename: Lauro Ferreira da Silva
authors.initials: LF
authors.lastname: Pinto Neto
authors.forename: Mariza Barros
authors.initials: MB
authors.lastname: das Neves
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Ribeiro-Rodrigues
authors.forename: Kimberly
authors.initials: K
authors.lastname: Page
authors.forename: Angelica Espinosa
authors.initials: AE
authors.lastname: Miranda
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism*; D001938:Brazil; D015331:Cohort Studies; D050171:Dyslipidemias / Q000175:diagnosis / Q000209:etiology*; D005215:Fasting / Q000097:blood*; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D019380:Anti-HIV Agents; D001786:Blood Glucose
keywords: AIDS; ART; Co-morbidity; Dyslipidemia; Fasting glucose