Lipid profiles of HIV-infected diabetic patients

Background: Despite highly active antiretroviral therapy (HAART) leading to a decline in human immunodeficiency virus (HIV)-induced morbidity and mortality, in recent years HAART has been implicated in abnormal lipid profiles, diabetes mellitus (DM) and predisposition of patients to cardiovascular disease (CVD). Objectives: In this comparative study, the side effects of HAART as well as other lifestyle factors such as diet, exercise, alcohol and/or smoking were assessed, as well as family history of diabetes between HIV-infected and HIV-uninfected patients of African ancestry with DM. Methods: The study population consisted of 80 Black African diabetic patients (18–65 years old) stratified by HIV status (HIV-infected n = 40; HIV-uninfected n = 40). Anthropometric measurements (weight, height and BMI) and blood pressure (BP), as well as biochemical tests for glucose, cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL) and triglycerides were performed. Results: The median BMI indicated overweight in the HIV-infected compared with the HIV-uninfected, which was congruent with obesity. Systolic BP was higher in the HIV-infected compared with the HIV-uninfected groups, at 138.15 and 134.75 mmHg (p = 0.1651), respectively. Glucose was high in both groups, confirming diabetes (p = 0.3900). Cholesterol was high (4.85 mmol/l) in the HIV-infected group while HDL was lower (0.95 mmol/l) in the HIV-uninfected group. Triglycerides were elevated in the HIV-uninfected (1.90 mmol/l) compared with the HIV-infected (1.61 mmol/l) (p = 0.7500) group. Conclusion: Despite HAART being documented as a contributor to DM and abnormal lipid profiles in the HIV-infected group, lifestyle factors such as diet also affect obesity phenotype in the uninfected group. Thus, irrespective of DM and/or HIV status, a lack of exercise, behavioural and lifestyle risk factors exacerbate abnormal lipid profiles. Notably, a family history of DM showed a strong susceptibility to its development.