Lipid Disorders in Untreated HIV Patients A New Insight into Disease Progression and Metabolic Risk

Introduction

Understanding how HIV impacts the body before the onset of treatment is critical. A recent study from the University Teaching Hospital of Kinshasa (UTHK), Democratic Republic of the Congo, sheds new light on lipid abnormalities in antiretroviral therapy (ART) naive HIV-infected patients. These insights underscore the metabolic risks posed by HIV itself and not just the treatment.
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Background and Significance

In HIV-infected individuals not yet on ART, chronic immune activation and inflammation often go unnoticed until metabolic disturbances emerge. One key manifestation is dyslipidaemiaa disruption in lipid profileswhich has serious cardiovascular implications.

The study from UTHK analyzed data from 270 HIV-positive patients over a span of six years (2008–2014), highlighting the early onset of these lipid imbalances and their potential as prognostic indicators for disease progression.

Key Findings from the Study

• Only 38.8% of the 270 patients underwent lipid assessment.
• Among those tested, 38.1% had dyslipidaemia.
• Breakdown of abnormalities:
  • 42.9% had low HDL-C levels.
  • 28.6% had hypercholesterolemia.
  • 23.8% had elevated triglycerides.
  • 19% had high LDL-C levels.

These changes were strongly correlated with lower CD4+ counts, especially below 200 cells/µL, indicating advanced immunosuppression.

Biological and Clinical Implications

Patients presenting with dyslipidaemia showed:

• Significantly higher blood sugar levels.
• Elevated white blood cell (WBC) counts.
• Lower hemoglobin levels.
• Greater likelihood of co-existing tuberculosis (TB) and anemia.

Such metabolic shifts were more pronounced in women, individuals in WHO Stage 4, and those with hyperglycemiaeach independently increasing the risk of dyslipidaemia by 2 to 9 times.

Integration with External Medical Guidelines

The World Health Organization (WHO) recommends routine lipid screening in HIV management. However, due to limited resources in regions like the DRC, lipid profiling often remains an unmet need.

According to the American Heart Association (AHA), dyslipidaemia is a well-recognized risk factor for cardiovascular diseasesconditions that are increasingly common in people living with HIV (PLWH) as life expectancy improves through ART.

Reference to the Study

For full access to the research, read the original study at:
https://doi.org/10.29328/journal.ijcv.1001023

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