Prevalence of HIV-Associated Metabolic Abnormalities among Patients Taking First-Line Antiretroviral Therapy in Uganda.
Introduction. While the introduction of highly active antiretroviral therapy decreased HIV-related morbidity and mortality rates in the sub-Saharan Africa, a subsequent increase in metabolic abnormalities has been observed. We sought to determine the prevalence of HIV-associated metabolic abnormalities among patients on first-line antiretroviral therapy (ART) in an ART clinic in Kampala, Uganda. Methods. Four hundred forty-two consecutive patients on first-line ART for at least 12 months were screened for eligibility in a cross-sectional study, and 423 were enrolled. Pre-ART patient characteristics were abstracted from medical charts, examinations included anthropometric measurement and physical assessment for lipodystrophy. Results. The prevalence of hyperglycemia and dyslipidemia was 16.3% (69/423) and 81.5% (345/423), respectively. Prevalence of dyslipidemia between stavudine- and zidovudine-based regimens (91% versus 72%; P < 0.001). Being on stavudine (aOR 4.79, 95%, 2.45-9.38) and peak body weight (aOR 1.44, 95% CI 1.05-1.97) were independent risk factors for dylipidemia. Stavudine (aOR 0.50, 95% CI  0.27-0.93) use was associated with lower risk for hyperglycemia while, and older age (aOR 1.31, 95% CI 1.11-1.56) and having a family history of DM (aOR 2.18, 95% CI 1.10-4.34) were independent risk factors for hyperglycemia. Conclusions. HIV-associated metabolic complications were prevalent among patients on thymidine analogue-containing ART regimens. Screening for lipid and glucose abnormalities should be considered in ART patients because of cardiovascular risks.
School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
Bernard
B
Omech
Joseph
J
Sempa
Barbara
B
Castelnuovo
Kenneth
K
Opio
Marcel
M
Otim
Harriet
H
Mayanja-Kizza
Robert
R
Colebunders
Yukari C
YC
Manabe