Pattern of dyslipidaemia in human immunodeficiency virus infected patients- a study from rural tertiary care hospital in central India

Nisar A. Wafai, Khwaja Saifullah Zafar, Manoj Kumar, Prem S. Singh, Sudhir K. Yadav


Background: HIV/AIDS is a major health problem affecting the whole globe. With introduction of highly active antiretroviral therapy longevity of HIV patient have increased and they are subjected to high cardiovascular risk as age increases due to various risk factors. Of these dyslipidaemia is one of important risk factor and HIV patients have different degree of deranged lipid profile. Various studies have shown different lipid derangement in these patients but most of them were conducted in urban areas, so this study was conducted to look for lipid profile in HIV patients who are resident of rural areas. 

Methods: This study was conducted on 66 HIV infected or AIDS cases. Each case was subjected to history taking, through clinical examination and fasting lipid levels. Dyslipidaemia was a classified using NCEP/ATP III guideline.

Results: Of total 66 cases, there were 39 male and 27 female with average age of 37 years. Hypercholesterolemia was present in 50% of patients, hypertriglyceridemia in 36.4%. LDL and VLDL were raised in 37.9% and 36.4% respectably while HDL was found below 40 mg/dl in 37.9% of the patients. S. total cholesterol, HDL and LDL was found to have positive correlation while S. TG and VLDL have no significant correlation with CD4 count.

Conclusions: Present studies have shown high prevalence of dyslipidaemia in different WHO clinical stage with variable correlation with CD4 count.


CD4 count, Dyslipidaemia, HIV/AIDS, Rural

Full Text:



Cohen MS, Hellmann N, Levy JA, DeCock K, Lange J. The spread, treatment, and prevention of HIV-1: evolution of a global pandemic. J Clin Invest. 2008;118(4):1244-54.

HIV/AIDS Fact sheet 2015. WHO. November 2015. Retrieved 11 April 2016.

Annual report NACO, 2014 -15; Ministry of Health & Family Welfare, Government of India, Delhi, 2014.

Centers for Disease Control (CDC). 'Kaposi's Sarcoma and Pneumocystis Pneumonia among Homosexual Men- New York City and California' MMWR Weekly. 1981;30(4):305-308.

Centers for Disease Control (CDC) Current Trends Update on Acquired Immune Deficiency Syndrome (AIDS) --United States. 1982;31(37):507-8,513-4.

Aldaz P, Moreno-Iribas C, Egüés N, Irisarri F, Floristan Y, Sola-Boneta J, et al. Mortality by causes in HIV-infected adults: comparison with the general population. BMC Public Health. 2011;11:300.

Priscilla Y, Hsue MD, David D, Waters MD. What a Cardiologist needs to know about patient with HIV infection. Circulation. 2005;3947-57.

Lohse N, Hansen AB, Pedersen G, Kronborg G, Gerstoft J, Sørensen HT, et al. Survival of persons with and without HIV infection in Denmark. Ann Intern Med. 2007;146:87-95.

Carr A, Miller T, Law M, Cooper DA. A Syndrome of lipoatrophy, lactic acidaemia and liver dysfunction associated with HIV nucleoside analogue therapy: Contribution to HIV related lipodystrophy syndrome. AIDS. 2000;14:25-72.

Périard D, Telenti A, Sudre P, Cheseaux JJ, Halfon P, Reymond MJ, et al. Atherogenic dyslipidemia in HIV infected individuals treated with protease inhibitors. The Swiss HIV cohort study. Circulation. 1999;100(7):700-5.

Ridler SA, Smit E, Cole SR. Impact of HIV infection on serum lipids in men. JAMA. 2003;289: 2882-978.

Mondy K, Overton ET, Grubb I. Metabolic Syndrome in HIV- infected patients from an urban Midwestern US outpatient population. Clin Infect Dis. 2007;44:726-34.

Buchacz K, Weidle PJ, Moore D. Changes in lipid profiles over 24 months in adults on first line highly active antiretroviral therapy in the home based care in rural Uganda. J Acquir Immune Defic Syndr. 2008;47:304-11.

Grunfeld C, Kotler DP, Shigenaga JK, Doerrler W, Tierney A, Wang J, et al. Circulating Interferon-alpha levels and Hypertriglyceridaemia in the Acquired immunodeficiency Syndrome. Am J Med. 1991;90:154-62.

Grunfeld C, Pang M, Doerrler W, Shigenaga JK, Jensen P, Feingold KR. Lipids, lipoproteins, triglyceride clearance, and cytokines in human immunodeficiency virus infection and the acquired immunodeficiency syndrome. J Clin Endocrinol Metab. 1992;74:1045–52.

Hellerstein MK, Grunfeld C, Wu K, et al. Increased de novo hepatic lipogenesis in human immunodeficiency virus infection. J Clin Endocrinol Metab. 1993;76:559-65.

Lewis GF, Rader DJ. New insights into the regulation of HDL metabolism and reverse cholesterol transport. Circ Res. 2005;96:1221-32.

Rose H1, Hoy J, Woolley I, Tchoua U, Bukrinsky M, Dart A, et al. HIV infection and high density lipoprotein metabolism. Atherosclerosis. 2008;199:79-86.

van der Valk M1, Gisolf EH, Reiss P, Wit FW, Japour A, Weverling GJ, et al. Increased risk of lipodystrophy when nucleoside analogue reverse transcriptase inhibitors are included with protease inhibitors in the treatment of HIV-1 infection. AIDS. 2001;15:847-55.

Currier JS1, Taylor A, Boyd F, Dezii CM, Kawabata H, Burtcel B, et al. Coronary heart disease in HIV-infected individuals. J acquired immune deficiency syndromes. 2003;33(4):506-12.

National AIDS Control Organisation (NACO), Ministry of Health and Family Welfare. ART guidelines for HIV-Infected Adults and Adolescents: 2013. Government of India. 2013;11.

Allain CC, Poon LS, Chan CS, Richmond W, Fu PC. Enzymatic determination of Total Serum Cholesterols. Clin Chem. 1974;20(4):470-81.

Bucole G, Harold David. Quantitative determination of serum triglyceride by the use of enzymes. Clin Chem. 1973;19(5):476-81.

Friedwald WT, Levy RI, Frederickson DS. Estimation of the Concentration of Low Density Lipoprotein cholesterol in Plasma without use of preparative ultracentrifugation. Clin Chem. 1972;18:499-502.

Khiangte L, Vidyabati RK, Singh MK, Devi SB, Singh TR, Singh WG. A Study of Serum Lipid Profile in Human Immunodeficiency Virus (HIV) Infected Patients. JIACM. 2007;8(4):307-11.

Rogowska-Szadkowska D, Borzuchowska A. The levels of triglycerides, total cholesterol and HDL cholesterol in various stages of human immunodeficiency virus (HIV) infection. Pol Arch Med Wewn. 1999;101(2):145-50.

Ducobu J, Payen MC. Lipids and AIDS. Rev Med Brux. 2000;21(1):11-7.

Crook MA, Mir N. Abnormal lipids and the Acquired Immuno-Deficient Syndrome. Is there a problem and what should we do about it. Int J STD AIDS. 1999;10(6):353-6.

Shor-Posner G, Basit A, Lu Y, Cabrejos C, Chang J, Fletcher M, Mantero-Atienza E, et al. Hypocholesterolaemia is associated with Immune dysfunction in early Human Immunodeficiency Virus-1 infection. Am J Med. 1995;98(5):518.

Keréveur A, Cambillau M, Kazatchkine M, Moatti N. Lipoprotein anomalies in HIV infection. Ann Med Intern (Paris). 1996;147(5):333-43.

Matsuyama T, Koboyashi N, Yamamoto N. Cytokines and HIV infection. Is AIDS a Tumour necrosis Factor disease? AIDS. 1991;5:1405-17.