Lipid profiles of HIV-infected diabetic patients

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). 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. 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. 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. 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.