Morphological Changes in HIV-1 Infected Patients on Antiretroviral Therapy without Protease Inhibitors in Cameroon: A Prospective Cohort Study

The aim of this study was to determine the effect of HIV infection and of antiretroviral (ARV) therapy on lipid metabolism in order to help the clinicians to improve the management of HIV-infected patients. The lipid profile of 700 subjects of which 272 HIV-negative persons and 428 HIV-infected, treatment-Naive patients were evaluated. The 428 patients were put on 4 different ARV drugs: 201 patients on triple association Nevirapine/Stavudine (d4T)/Lamivudine, 177 on tritherapy Efavirenz (EFV)Stravudine/Lamivudine, 34 on combination Lamivudine/Zidovudine ZEfavirenz and 16 on association Zidovudine/Lamivudine/Nevirapine. The bodily changes of patients were measured during a period of two years of follow up. The overall prevalence of lipodystrophy increased significantly with the Lamivudine/Stavudine/Efavirenz ARV regimen, with breast lipodystrophy being the most frequent. There seems to be a high risk of developing lipodystrophy by HIV-infected patients during ARV therapy. Further, in the treatment regimen that contains d4T and EFV, the risk of developing metabolic disorders seems to be high.