EC Microbiology

The study recruited 154 HIV seropositive subjects visiting HIV Clinic at Abia State University Teaching Hospital, Aba. They were stratified into four groups. Group 1 and 2 were made up of 25 males and 62 females HIV seropositive subjects who were not yet on antiretroviral therapy, while group 3 and 4 are made up of 26 males and 41 females who were already on routine antiretroviral therapy (a combination of Lamivudine 150 mg, Zidovudine 300 mg and Nevirapine 200 mg) at least for the past 12 months. The age range of the study subjects was 15 to 55 years. Also, a total of 50 HIV seronegative subjects, made up of 20 males and 30 females participated in the study. They served as controls. The age range was 18 to 50 years. The study evaluated the cardiovascular risk factors and metabolic abnormalities in HIV seropositive subjects on therapy was categorized into biomarkers namely: Cardiovascular, metabolic, immunologic, renal function and haematologic markers. The cardiovascular markers evaluated include; serum lipids and high sensitivity c-reactive protein. HIV seropositive subjects who were not on therapy (non-ART) had decreased serum levels of total cholesterol (P < 0.001), no significant decreased serum levels of low-density lipoprotein and high-density lipoprotein cholesterols, as well as elevated mean ± SEM serum levels of triglyceride (P < 0.001) and high sensitivity C-reactive protein (P < 0.001) compared with HIV naïve subjects were observed. On the other hand, HIV seropositive subjects on antiretroviral therapy (ART) showed hypercholesterolemia, hypertriglyceridemia and elevated high sensitivity C-reactive protein (P < 0.001). LDL-cholesterol was not significantly increased and HDL-cholesterol was not significantly decreased. Upon comparison of cardiovascular markers in non-ART and ART subjects in both genders, in male ART subjects, results showed increased serum levels of total cholesterol (251.160 ± 9.106 mg/dl vs 238.76 ± 7.538 mg/dl), LDL-C (96.60 ± 5.584 mg/dl vs 88.20 ± 5.652 mg/dl), HDL-C (62.75 ± 2.725 mg/dl vs 56.52 ± 2.546 mg/dl), triglyceride (420.36 ± 30.184 mg/dl vs 398.64 ± 23.693 mg/dl) and high sensitivity c-reactive protein (3.616 ± 0.516 mg/dl vs 1.92 ± 0.601 mg/dl). The female subjects recorded similar result pattern with the male. The metabolic markers evaluated serum glucose, insulin, electrolytes and aminotransferases. In both genders, hyperinsulinemia was revealed in ART subjects with normoglycemia in both ART and non-ART subjects. Mean ± SEM serum electrolyte levels were not significantly reduced in non-ART subjects compared with ART subjects. However, they were all within the normal reference range. In male non-ART subjects, mean ± SEM serum levels of ALT (53.64 ± 3.768 iu/L) and AST (60.16 ± 3.432 iu/L) were not significantly increased when compared with ART subjects, ALT (42.52 ± 5.596 iu/L) and AST (46.24 ± 5.100 iu/L). In female subjects, the variation of the serum enzyme levels were very minor. The immunologic markers evaluated were CD4 cell count, CD3 cell count and high sensitivity C-reactive protein. CD4 cell count was significantly decreased in non-ART subjects compared with HIV naïve subjects (P < 0.001) while high sensitivity C-reactive protein serum mean ± SEM was significantly elevated in ART subjects (P < 0.001) and non-ART subjects (P < 0.05) respectively compared with HIV seronegative subjects. The degree of CD4 cell counts reduction was more in the non-ART subjects compared with the ART subjects in both male and female subjects. On the other hand, the degree of hsCRP elevation was more on ART subjects compared with non-ART subjects in both genders (P < 0.001). The renal function markers evaluated weight, serum creatinine and creatinine clearance levels. There was reduction in the weight of non-ART subjects (58.724 ± 1.341 kg) and ART subjects (62.075 ± 1.358 kg) respectively compared with HIV seronegative subjects (67.72 ± 1.503 kg). Also, the mean ± SEM serum clearance levels were elevated in non-ART subjects (0.783 ± 0.0953 mg/dl) and ART subjects (0.732 ± 0.0315 mg/dl). Also, the creatinine clearance was reduced in non-ART subjects (128.722 ± 4.110 ml/min) and ART subjects (131.376 ± 4.511 ml/min) respectively compared with HIV naïve subjects (149.47 ± 2.979 ml/min). In male subjects, creatinine clearance was reduced in ART subjects compared with non-ART subjects. Serum creatinine level was also not significantly higher in ART subjects compared with non-ART subjects. This discordant was due to weight disparity. Non-ART subjects had higher weight than ART subjects. On the other hand, the reverse was recorded in female subjects. Non-ART subjects had non-significantly lower creatinine clearance value, and higher serum clearance level and reduced mean ± sem weight when compared with ART subjects. The haematological markers revealed remarkable abnormalities in both male and female subjects, where statistically significant thrombocytopenia, anaemia, neutropenia and lymphocytosis were recorded in non-ART subjects compared with ART subjects and HIV naïve subjects respectively (P < 0.001). In both genders, moderate increases in monocyte and decreases in total white blood cell count were recorded in non-ART subjects.

Keywords: HIV; AIDS; Antiretroviral; Cardiovascular; HAART

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