Insulin Resistance Dyslipidemia And Cardiovascular Disease Risk In Hiv-1 Infected Adults Receiving Protease Inhibitor Based Combined Antiretroviral Therapy In The Art Clinic Of Tikur Anbessa Referral Hospital.

Treatment with highly active antiretroviral therapy (HAART) has improved the prognosis of patientsrnwith AIDS. However, it has also increased the incidence of various metabolic disorders, in particularrninsulin resistance accompanied by dyslipidaemia, hyperglycaemia and lipodystrophy. This is oftenrnpredispose to type 2 diabetes and increased mortality from cardiovascular disease which is more commonrnin protease inhibitor based regimen.rnrnThis cross sectional study was designed to assess the occurrence of insulin resistance, dyslipidemia andrncardiovascular disease risk in HIV-1 infected adults taking protease inhibitor based combinedrnantiretroviral therapy and to compare with those taking NNRTI-based regimen in a total of 134 subjectsrnthat contain equal number of cases and controls. Accordingly, variables like age, sex, type of regimen,rnduration of ART were collected and anthropometric variables and blood pressure was measured.rnMoreover, biochemical variables like glucose, insulin and lipid profile were determined using standardrnand calibrated clinical chemistry analyzers along with a parallel control run in a fasting serum samplerncollected from the patients. HOMA and total cholesterol to HDL ratio as well as triglyceride to HDL ratiornwere also calculated using a standard formula.rnrnThe results revealed an elevated serum triglyceride concentration and a trend toward increase in insulinrnresistance on patients treated with PI-based regimen (cases), compared to NNRI-based regimen (controls).rnInsulin resistance was observed in 34.3% of the cases as compared to 28.4% in the controls as assessed byrnHOMA-IR. HOMA-IR mean values were similar and did not differ significantly between the two groups.rnDyslipidemia was also more prevalent among the cases as compared to the controls. Accordingly, 58.2%rnpatients on PI based regimen and 47.8% on NNRTI-based regimen had high cholesterol levels (> 5.1rnmmol/L). However, the difference was not statistically significant (p = 0.226) and the same is true for rntheir means (210 ± 41versus 200 ± 35, P = 0.137). Equally higher percentage of patients had high LDLrnlevel (>2.6 mmol/L) on both groups and there was no statistically significant difference in the proportionsrnas well as mean values between the two groups (65.7% versus 64.2%, p = 0.856; 109 ± 32 versus 112 ±rn31, p = 0.584). In this study, it appeared that hypertriglyceridemia (>1.7 mmol/L) affected almost three rnfourth (74.6%) of the patients on PI-based regimen and 34.3% on NNRTI-based regimen (p 3.8) (p

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