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Cardiometabolic risk, insulin resistance and immunity in HIV/AIDS patients receiving highly active retroviral therapy

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Abstract

Prior to the advent of HAART (Highly Active retroviral therapy), studies of insulin resistance in HIV infection showed normal insulin sensitivity. The metabolic disturbances due to HAART are now reported in our setting. To investigate potential associations between cardiometabolic indices, innate and adaptive immunity, adipokines, and markers of insulin resistance (IR) in HIV/AIDS patients on first-line antiretroviral therapy (ART) were studied. This cross-sectional study selected HIV/AIDS patients treated with ART at public clinics of Mthatha Municipality, South Africa. Age, waist-to-hip ratio, blood pressure, total cholesterol (TC), HDL-C, LDL-C, triglycerides, C-peptide, uric acid, C-reactive protein (CRP), glucose, and albuminuria were the cardiometabolic indices. Innate immunity (lymphocytes), adaptive immunity (CD4 cell count), adipokines (adiponectin, leptin), and insulin resistance markers—fasting serum Insulin and homeostasis model assessment—IR score were also explored. Out of 258 selected patients, aged 38.1 ± 9.3 years, 79.5 % were females. There was a univariate correlation between HOMA-IR score and triglyceride (r = 0.331; P < 0.0001), uric acid (r = 0.386; P = 0.008), albuminuria (r = 0.316; P < 0.0001), adiponectin (r = −0.322; P = 0.035), lymphocytes (r = 0.186; P = 0.04) and waist-to-hip ratio (r = 0.217; P = 0.013), and HOMA-IR score. C-peptide was correlated with serum Insulin (r = 0.694; P < 0.0001). After adjusting for confounding factors, only triglycerides and C-Peptide independently and significantly explained 64.1 % of the variance in HOMA-IR score. Patients receiving ART are at higher risk for diabetes mellitus, cardiovascular disease and chronic renal disease. Regular monitoring of patients on first-line anti-retroviral agents is imperative to detect these cardiometabolic risk factors and allow for treatment to be initiated early.

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Authors and Affiliations

  1. Department of Physiology, Faculty of Health Sciences, Walter Sisulu University, Mthatha, Eastern Cape Province, South Africa

    Kofoworola Awotedu

  2. Department of Internal Medicine, Faculty of Health Sciences, Walter Sisulu University, Mthatha, Eastern Cape Province, South Africa

    Benjamin Longo-Mbenza, Abolade Awotedu & Chukwuma Ekpebegh

  3. Department of Statistics, Walter Sisulu University, Mthatha, South Africa

    John Sungwacha Nasila

  4. Walter Sisulu University, Faculty of Health Sciences, Private Bag X1, Mthatha, 5117, Eastern Cape, South Africa

    Benjamin Longo-Mbenza

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  1. Kofoworola Awotedu
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Correspondence to Benjamin Longo-Mbenza.

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Awotedu, K., Longo-Mbenza, B., Nasila, J.S. et al. Cardiometabolic risk, insulin resistance and immunity in HIV/AIDS patients receiving highly active retroviral therapy. Int J Diabetes Dev Ctries 32, 145–150 (2012). https://doi.org/10.1007/s13410-012-0082-2

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