Department of Physiological Sciences

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Browsing Department of Physiological Sciences by Author "Abaid, Faten E. Bashir"

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    Cardio-metabolic effects of anti-retroviral treatment in the Cape Winelands region of South Africa
    (Stellenbosch : Stellenbosch University, 2016-03) Abaid, Faten E. Bashir; Essop, M. Faadiel; Stellenbosch University. Faculty of Science. Dept. of Physiological Sciences.
    ENGLISH ABSTRACT: Background: Although highly active antiretroviral therapy (HAART) has significantly improved the survival of human immunodeficiency virus (HIV)-infected patients there are increased concerns regarding the onset of co-morbidities (e.g. cardio-metabolic complications) and mortalities. Although South Africa is burdened with the highest number of HIV-infected individuals globally, there is a relative paucity of data regarding potential links between HIV infection, HAART and cardio-metabolic risk/onset. Methods: This cross-sectional study therefore investigated the prevalence of cardio-metabolic risk factors in HIV-infected individuals within the Cape Winelands region of South Africa. Here we collected anthropometric, biochemical and lifestyle-related data for HIV-positive HAART naive (n =25) and HIV-positive individuals on HAART (n = 50) patients (20–55 years old) at the Worcester Community Day Centre (CDC) (Worcester, Western Cape, South Africa) during 2014 and 2015. Subjects on HAART were further divided into two sub-groupings, i.e. first line (n = 25) and second line treatments (n = 25). Results: Our data reveal the relatively high prevalence of traditional, cardio-metabolic lifestyle risk factors in HIV-infected individuals. There was a relatively high prevalence of smoking, i.e. 88% for the HIV-positive HAART naive group and 27% for the HIV-positive group on HAART (P = 0.001), while more than half of the HIV-positive individuals exhibited a positive history of familial cardiovascular diseases (CVD). There were no significant differences for fasting blood glucose (FBG) and insulin levels between HIV-positive HAART naive and HIV-positive on HAART. Lipid metabolite analyses (Total cholesterol [TC], low-density lipoprotein [LDL], high density lipoprotein [HDL] and triglyceride [TG]) also did not reveal significant changes when comparing HIV-positive on HAART versus HIV-positive HAART naive groups. However, additional analyses (using established cut-off values for HDL, LDL) showed a significant difference in the proportion of individuals categorized with ‘’low HDL’’ status, i.e. 68% for the HIV-positive HAART naive compared to 40% for the HIV-positive on HAART group (P =0.022). HAART also enhanced anthropometric measures of obesity, with significant differences for weight gain, triceps skin fold (TSF), biceps skin fold (BSF), waist circumference (WC) and mid-upper arm circumference (MUAC) between the naive and HAART groups. This applied similarly for first and second line treatments. Conclusion: The study established the prevalence of several traditional lifestyle CVD risk factors in both HIV-positive naive and HIV-positive on HAART in the Cape Winelands region of South Africa. HAART enhanced several measure of weight gain and lipid profile, suggesting a restoration to health and well-being. However, there was a relatively high prevalence of obesity in the HIV-positive on HAART group (especially females) thus placing them at a greater risk for the onset of future cardio-metabolic complications. We are unable to distinguish whether this risk is due to HAART or lifestyle-related risk factors, and this question requires further investigation. The findings of this study indicate that clinicians should be attentive of lifestyle-related CVD risk factors in HIV-positive persons and make an effort to counsel patients to adopt improved lifestyle choices.