Forthcoming Issue Vol 19 No. 3 Fasting Lipid Profile of HIV-infected Children on Antiretroviral Therapy Living in an area of prolonged armed Conflict
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Abstract
Background: North-eastern region of Nigeria has been engulfed in an armed conflict for over a decade with over 2 million people displaced internally. This has led to disruption of health care services particularly among people living with chronic illnesses like HIV. Disruption of ARVs therapy leads to drug resistance and subsequent switch to PI-based 2nd line regimen which has been severally linked to dyslipidaemia. The study thus determined the prevalence of lipid abnormalities among HIV positive children on ART and associated factors in an area under prolonged armed conflict.
Methods— This was a descriptive analytic cross-sectional study that involved 249 HIV-positive children aged 2-15 years on ART, selected by systematic random sampling. Their socio-demographic and clinical characteristics were recorded in a proforma. Fasting serum lipids were measured using enzymatic methods and low-density lipoprotein (LDL-c) was calculated using the Friedewald formula and data was analyzed using SPSS version 26.
Results—The prevalence of dyslipidaemia was 63.1% and hypertriglyceridaemia was the most prevalent type 96 (38.6%). Others include: hypercholesterolaemia 78 (32.3%), high LDL 62 (24.9%) and, 53 (21.3%) for low HDL. Long duration on ART (p<0.001), Severe disease (p=0.031), and PI-based regimen (p=0.016) were significantly associated with dyslipidaemia. All the 55 children who experienced therapy interruption due to displacement by the conflict were switched to PI-based regimen.
Conclusion—The prevalence of dyslipidemia among HIV positive children on ART at UMTH was high and hypertriglyceridaemia was the most prevalent type. Factors associated with dyslipidaemia include Severe HIV disease, long duration on ART and PI-based regimen. Treatment interruption leading to switch to PI-based regimen is the major effect of the conflict on therapy and indirectly on lipid profile. We recommend routine fasting serum lipid determination in all HIV positive children particularly those on PI-based regimen, greater than 5 years on ART and severe disease.
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