Metabolic abnormalities in adult HIV infected population on antiretroviral medication in Malaysia: A cross-sectional survey

Nazisa Hejazi, Roslee Rajikan, Christopher Lee Kwok Choong, Suzana Sahar

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: In the current two decades, dyslipidemia and increased blood glucose as metabolic abnormalities are the most common health threats with a high incidence among HIV/AIDS patients on antiretroviral (ARV) treatment. Scientific investigations and reports on lipid and glucose disorders among HIV infected communities are inadequate especially in those developing such as Malaysia. This cross-sectional survey was mainly aimed to evaluate the prevalence of metabolic abnormalities and associated risk factors among HIV infected population patients on ARV medication. Methods. In a single reference health center in Malaysia, 2739 adult HIV positive patients on antiretroviral therapy (ART) were studied cross-sectionally using medical records. Besides demographic variables and associated health disorders, those factors which can change the lipid and glucose levels were collected. Logistic Regression was used to find the potential risk factors (p < 0.05). Results: Majority of the studied population were male (81.1%) and aged between 30-49 (68.6%). Mean CD4 count was 474.25 (cells/mm§ssup§3§esup§) while undetectable RNA viral load was common among 83.3 (%) of subjects. Among 1,583 patients with the recent blood lipid and glucose tests, increased levels of triglyceride (TG) and total cholesterol (TC) were frequently prevalent in half of the population as 59 (%) and 54.2 (%) while 28.7 (%), 35.1 (%) and 38.2 (%) had declined level of high-density lipoprotein (HDL), raised low-density lipoprotein (LDL) and fasting plasma glucose (FPG) which were less common. Dyslipidemia was common in 82.3 (%) of the subjects. Notably, medication with protease inhibitor (PI) was a potential risk for elevated triglyceride (odds ratio (OR) = 2.309, 95% confidence interval (CI) = 1.605-3.324, P = 0.001), high TC (OR = 1.561, 95% CI = 1.123-2.169, P = 0.008) and low HDL (OR = 1.449, 95% CI = 1.037-2.024, P = 0.029). As lifestyle factor, alcohol consumption results as significant risk factor for raised TG (OR = 2.653, 95% CI = 1.353-5.202, P = 0.004). Also having hepatitis raised risk of high FPG level (OR = 1.630, 95% CI = 1.197-2.220, P = 0.002) in this sample population. Conclusions: Dyslipidemia is highly common in Malaysian HIV subjects receiving ARV medication. Lifestyle modification, changing PI and switch to other ARV regimen can help in reduction of these abnormalities. Also suitable strategies and plans are necessary to prevent cardiovascular diseases in future.

Original languageEnglish
Article number758
JournalBMC Public Health
Volume13
Issue number1
DOIs
Publication statusPublished - 2013

Fingerprint

Malaysia
Cross-Sectional Studies
Odds Ratio
HIV
Confidence Intervals
Dyslipidemias
Glucose
Triglycerides
Population
HDL Lipoproteins
Protease Inhibitors
Lipids
LDL Lipoproteins
Blood Glucose
Life Style
Fasting
Health
Cholesterol
CD4 Lymphocyte Count
Viral Load

Keywords

  • ARV medication
  • Cardiovascular disease
  • Dyslipidemia
  • Fasting plasma glucose
  • HIV positive
  • Lipid disorders
  • Malaysia
  • Metabolic abnormalities
  • Protease inhibitor

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Metabolic abnormalities in adult HIV infected population on antiretroviral medication in Malaysia : A cross-sectional survey. / Hejazi, Nazisa; Rajikan, Roslee; Kwok Choong, Christopher Lee; Sahar, Suzana.

In: BMC Public Health, Vol. 13, No. 1, 758, 2013.

Research output: Contribution to journalArticle

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title = "Metabolic abnormalities in adult HIV infected population on antiretroviral medication in Malaysia: A cross-sectional survey",
abstract = "Background: In the current two decades, dyslipidemia and increased blood glucose as metabolic abnormalities are the most common health threats with a high incidence among HIV/AIDS patients on antiretroviral (ARV) treatment. Scientific investigations and reports on lipid and glucose disorders among HIV infected communities are inadequate especially in those developing such as Malaysia. This cross-sectional survey was mainly aimed to evaluate the prevalence of metabolic abnormalities and associated risk factors among HIV infected population patients on ARV medication. Methods. In a single reference health center in Malaysia, 2739 adult HIV positive patients on antiretroviral therapy (ART) were studied cross-sectionally using medical records. Besides demographic variables and associated health disorders, those factors which can change the lipid and glucose levels were collected. Logistic Regression was used to find the potential risk factors (p < 0.05). Results: Majority of the studied population were male (81.1{\%}) and aged between 30-49 (68.6{\%}). Mean CD4 count was 474.25 (cells/mm§ssup§3§esup§) while undetectable RNA viral load was common among 83.3 ({\%}) of subjects. Among 1,583 patients with the recent blood lipid and glucose tests, increased levels of triglyceride (TG) and total cholesterol (TC) were frequently prevalent in half of the population as 59 ({\%}) and 54.2 ({\%}) while 28.7 ({\%}), 35.1 ({\%}) and 38.2 ({\%}) had declined level of high-density lipoprotein (HDL), raised low-density lipoprotein (LDL) and fasting plasma glucose (FPG) which were less common. Dyslipidemia was common in 82.3 ({\%}) of the subjects. Notably, medication with protease inhibitor (PI) was a potential risk for elevated triglyceride (odds ratio (OR) = 2.309, 95{\%} confidence interval (CI) = 1.605-3.324, P = 0.001), high TC (OR = 1.561, 95{\%} CI = 1.123-2.169, P = 0.008) and low HDL (OR = 1.449, 95{\%} CI = 1.037-2.024, P = 0.029). As lifestyle factor, alcohol consumption results as significant risk factor for raised TG (OR = 2.653, 95{\%} CI = 1.353-5.202, P = 0.004). Also having hepatitis raised risk of high FPG level (OR = 1.630, 95{\%} CI = 1.197-2.220, P = 0.002) in this sample population. Conclusions: Dyslipidemia is highly common in Malaysian HIV subjects receiving ARV medication. Lifestyle modification, changing PI and switch to other ARV regimen can help in reduction of these abnormalities. Also suitable strategies and plans are necessary to prevent cardiovascular diseases in future.",
keywords = "ARV medication, Cardiovascular disease, Dyslipidemia, Fasting plasma glucose, HIV positive, Lipid disorders, Malaysia, Metabolic abnormalities, Protease inhibitor",
author = "Nazisa Hejazi and Roslee Rajikan and {Kwok Choong}, {Christopher Lee} and Suzana Sahar",
year = "2013",
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T1 - Metabolic abnormalities in adult HIV infected population on antiretroviral medication in Malaysia

T2 - A cross-sectional survey

AU - Hejazi, Nazisa

AU - Rajikan, Roslee

AU - Kwok Choong, Christopher Lee

AU - Sahar, Suzana

PY - 2013

Y1 - 2013

N2 - Background: In the current two decades, dyslipidemia and increased blood glucose as metabolic abnormalities are the most common health threats with a high incidence among HIV/AIDS patients on antiretroviral (ARV) treatment. Scientific investigations and reports on lipid and glucose disorders among HIV infected communities are inadequate especially in those developing such as Malaysia. This cross-sectional survey was mainly aimed to evaluate the prevalence of metabolic abnormalities and associated risk factors among HIV infected population patients on ARV medication. Methods. In a single reference health center in Malaysia, 2739 adult HIV positive patients on antiretroviral therapy (ART) were studied cross-sectionally using medical records. Besides demographic variables and associated health disorders, those factors which can change the lipid and glucose levels were collected. Logistic Regression was used to find the potential risk factors (p < 0.05). Results: Majority of the studied population were male (81.1%) and aged between 30-49 (68.6%). Mean CD4 count was 474.25 (cells/mm§ssup§3§esup§) while undetectable RNA viral load was common among 83.3 (%) of subjects. Among 1,583 patients with the recent blood lipid and glucose tests, increased levels of triglyceride (TG) and total cholesterol (TC) were frequently prevalent in half of the population as 59 (%) and 54.2 (%) while 28.7 (%), 35.1 (%) and 38.2 (%) had declined level of high-density lipoprotein (HDL), raised low-density lipoprotein (LDL) and fasting plasma glucose (FPG) which were less common. Dyslipidemia was common in 82.3 (%) of the subjects. Notably, medication with protease inhibitor (PI) was a potential risk for elevated triglyceride (odds ratio (OR) = 2.309, 95% confidence interval (CI) = 1.605-3.324, P = 0.001), high TC (OR = 1.561, 95% CI = 1.123-2.169, P = 0.008) and low HDL (OR = 1.449, 95% CI = 1.037-2.024, P = 0.029). As lifestyle factor, alcohol consumption results as significant risk factor for raised TG (OR = 2.653, 95% CI = 1.353-5.202, P = 0.004). Also having hepatitis raised risk of high FPG level (OR = 1.630, 95% CI = 1.197-2.220, P = 0.002) in this sample population. Conclusions: Dyslipidemia is highly common in Malaysian HIV subjects receiving ARV medication. Lifestyle modification, changing PI and switch to other ARV regimen can help in reduction of these abnormalities. Also suitable strategies and plans are necessary to prevent cardiovascular diseases in future.

AB - Background: In the current two decades, dyslipidemia and increased blood glucose as metabolic abnormalities are the most common health threats with a high incidence among HIV/AIDS patients on antiretroviral (ARV) treatment. Scientific investigations and reports on lipid and glucose disorders among HIV infected communities are inadequate especially in those developing such as Malaysia. This cross-sectional survey was mainly aimed to evaluate the prevalence of metabolic abnormalities and associated risk factors among HIV infected population patients on ARV medication. Methods. In a single reference health center in Malaysia, 2739 adult HIV positive patients on antiretroviral therapy (ART) were studied cross-sectionally using medical records. Besides demographic variables and associated health disorders, those factors which can change the lipid and glucose levels were collected. Logistic Regression was used to find the potential risk factors (p < 0.05). Results: Majority of the studied population were male (81.1%) and aged between 30-49 (68.6%). Mean CD4 count was 474.25 (cells/mm§ssup§3§esup§) while undetectable RNA viral load was common among 83.3 (%) of subjects. Among 1,583 patients with the recent blood lipid and glucose tests, increased levels of triglyceride (TG) and total cholesterol (TC) were frequently prevalent in half of the population as 59 (%) and 54.2 (%) while 28.7 (%), 35.1 (%) and 38.2 (%) had declined level of high-density lipoprotein (HDL), raised low-density lipoprotein (LDL) and fasting plasma glucose (FPG) which were less common. Dyslipidemia was common in 82.3 (%) of the subjects. Notably, medication with protease inhibitor (PI) was a potential risk for elevated triglyceride (odds ratio (OR) = 2.309, 95% confidence interval (CI) = 1.605-3.324, P = 0.001), high TC (OR = 1.561, 95% CI = 1.123-2.169, P = 0.008) and low HDL (OR = 1.449, 95% CI = 1.037-2.024, P = 0.029). As lifestyle factor, alcohol consumption results as significant risk factor for raised TG (OR = 2.653, 95% CI = 1.353-5.202, P = 0.004). Also having hepatitis raised risk of high FPG level (OR = 1.630, 95% CI = 1.197-2.220, P = 0.002) in this sample population. Conclusions: Dyslipidemia is highly common in Malaysian HIV subjects receiving ARV medication. Lifestyle modification, changing PI and switch to other ARV regimen can help in reduction of these abnormalities. Also suitable strategies and plans are necessary to prevent cardiovascular diseases in future.

KW - ARV medication

KW - Cardiovascular disease

KW - Dyslipidemia

KW - Fasting plasma glucose

KW - HIV positive

KW - Lipid disorders

KW - Malaysia

KW - Metabolic abnormalities

KW - Protease inhibitor

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