Articles Vol. 67 No. CĐ11-NCKH 31/07/2026

DYSLIPIDEMIA AMONG PATIENTS WITH HIV RECEIVING ANTIRETROVIRAL THERAPY: A CROSS-SECTIONAL STUDY AT THE HOSPITAL FOR TROPICAL DISEASES

Nguyen Tran Quang Huy1,2, Vuong Minh Nhut3,4, Nguyen Quoc Viet5,6, Nguyen Le Nhu Tung5,6, Thai Duc Luan1,2, Vu Thi Hieu7,8, Vo Trieu Ly5,6
1 University of Health Sciences, Vietnam National University Ho Chi Minh City
2 Trường Đại học Khoa học Sức khỏe, Đại học Quốc gia TP.HCM
3 School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City
4 Trường Y, Đại học Y dược TP.HCM
5 Hospital for Tropical Diseases
6 Bệnh viện Bệnh Nhiệt đới
7 Pham Ngoc Thach Hospital
8 Bệnh viện Phạm Ngọc Thạch
DOI: 10.52163/yhc.v67iCD11.6040
73 Views
0 Downloads
Keywords
HIV/AIDS; antiretroviral therapy; dyslipidemia; dolutegravir.
Abstract

Background: Dyslipidemia is a common metabolic complication among people living with HIV receiving antiretroviral therapy. As dolutegravir has become a cornerstone of first-line antiretroviral regimens, real-world data on lipid abnormalities among patients receiving dolutegravir-based therapy in low- and middle-income settings remain limited.

Objective: To determine the prevalence of dyslipidemia, patterns of lipid abnormalities, and associated factors among HIV-infected patients receiving ART at the Hospital for Tropical Diseases.

Methods: A cross-sectional study was conducted among 199 adult patients living with HIV who had been receiving antiretroviral therapy for at least one year at the Hospital for Tropical Diseases between August 2023 and July 2024. Dyslipidemia was defined as the presence of at least one abnormal lipid parameter (total cholesterol, triglycerides, LDL-C, or HDL-C). Logistic regression analyses were performed to identify factors associated with specific lipid abnormalities.

Results: The overall prevalence of dyslipidemia was 84.9%, with low HDL-C being the most common dyslipidemia. In multivariable analyses, body mass index (aOR = 1,15) and duration of antiretroviral (aOR = 1,07) therapy were independently associated with hypertriglyceridemia, while low HDL-C was independently associated with lower baseline CD4 cell count (aOR = 3,70). Regimens containing lopinavir/ritonavir  (aOR = 3,83) were associated with a higher risk of hypercholesterolemia, whereas dolutegravir-based regimens were associated with a significantly lower prevalence of total cholesterol abnormalities. 

Conclusions: Dyslipidemia is common among patients with HIV receiving antiretroviral therapy and predominantly manifests as an atherogenic–metabolic pattern characterized by low HDL cholesterol and elevated triglyceride levels rather than isolated hypercholesterolemia. These findings underscore the importance of comprehensive lipid assessment and the preferential use of metabolically favorable regimens in the long-term management of HIV infection.

References
[1]
Kalra DK, Vorla M, Michos ED, Agarwala A, Virani S, Duell PB, et al. Dyslipidemia in Human Immunodeficiency Virus Disease: JACC Review Topic of the Week. Journal of the American College of Cardiology. 2023;82(2):171-81. DOI: 10.1016/j.jacc.2023.04.050 Google Scholar
[2]
Đoàn Thu Trà, Ngô Văn An, Đỗ Duy Cường. Rối loạn lipid máu trên người bệnh HIV/AIDS điều trị ARV ngoại trú tại bệnh viện Bạch Mai năm 2022. Tạp chí Y học Việt Nam. 2023;529(2). DOI: 10.51298/vmj.v529i2.6474 Google Scholar
[3]
Mizushima D, Dung NTH, Dung NT, Matsumoto S, Tanuma J, Gatanaga H, et al. Dyslipidemia and cardiovascular disease in Vietnamese people with HIV on antiretroviral therapy. Global Health & Medicine. 2020;2(1):39-43. DOI: 10.35772/ghm.2019.01035 Google Scholar
[4]
Bộ Y tế. Hướng dẫn chẩn đoán và điều trị bệnh nội tiết - chuyển hóa. 2015. p. 255-62. Google Scholar
[5]
Fiseha T, Alemu W, Dereje H, Tamir Z, Gebreweld A. Prevalence of dyslipidaemia among HIV-infected patients receiving combination antiretroviral therapy in North Shewa, Ethiopia. PLoS One. 2021;16(4):e0250328. DOI: 10.1371/journal.pone.0250328 Google Scholar
[6]
Li X, Song X, Han Y, Qiu Z, Cao W, Li T. Risk factors and longitudinal changes of dyslipidemia among Chinese people living with HIV receiving antiretroviral therapy. BMC Infect Dis. 2023;23(1):598. DOI: 10.1186/s12879-023-08587-0 Google Scholar
[7]
Kemal A, Teshome MS, Ahmed M, Molla M, Malik T, Mohammed J, et al. Dyslipidemia and Associated Factors Among Adult Patients on Antiretroviral Therapy in Armed Force Comprehensive and Specialized Hospital, Addis Ababa, Ethiopia. HIV AIDS (Auckl). 2020;12:221-31. DOI: 10.2147/hiv.S252391 Google Scholar
[8]
Kigongo VJ, Nankabirwa JI, Kitutu FE, Ssenyonga R, Mutebi RK, Kazibwe A, et al. Dyslipidemia among adult people living with HIV on dolutegravir - based antiretroviral therapy at a private tertiary hospital in Kampala, Uganda: burden and determinants. BMC Infect Dis. 2024;24(1):53. DOI: 10.1186/s12879-023-08892-8 Google Scholar
[9]
Puerta S, Palacios R, Orihuela F, Torre J, Fernandez S, Grana M, et al. Factors related to low HDL-cholesterol in HIV-infected patients. Journal of The International Aids Society - J Int AIDS Soc. 2008;11. DOI: 10.1186/1758-2652-11-S1-P112 Google Scholar
[10]
Kumarasamy N, Aga E, Ribaudo HJ, Wallis CL, Katzenstein DA, Stevens WS, et al. Lopinavir/Ritonavir Monotherapy as Second-line Antiretroviral Treatment in Resource-Limited Settings: Week 104 Analysis of AIDS Clinical Trials Group (ACTG) A5230. Clin Infect Dis. 2015;60(10):1552-8. DOI: 10.1093/cid/civ109 Google Scholar