The effect of antiretroviral therapy in newly diagnosed people living with HIV and AIDS, and their correlation with common inflammatory markers and lipid profile
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Mahatma Gandhi Memorial Medical College, Indore, India
Submission date: 2023-07-14
Acceptance date: 2023-07-23
Online publication date: 2024-05-13
Corresponding author
Sumeet Kumar   

Mahatma Gandhi Memorial Medical College
HIV & AIDS Review 2024;23(2):130-135
Studies have shown that there is a connection between erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), lipid profile, and death among individuals with acquired immunodeficiency syndrome (AIDS) not taking human immunodeficiency virus (HIV) medications. Those, who later developed AIDS or died during the analysis had their inflammatory markers measured (tumor necrosis factor – TNF, interleukin (IL)-6, CD27, ESR, and CRP). This study was conducted with the aim to evaluate the role of antiretroviral therapy (ART) in newly diagnosed people living with HIV and AIDS (PLWHA), and their correlation with inflammatory markers and lipid profile.

Material and methods:
This prospective study was conducted among 222 newly diagnosed PLWHA arriving at ART center or in-patients for a duration of one year. 181 were started on TLD (tenofovir disoproxil fumarate, lamivudine, and dolutegravir), and 41 on TLE (tenofovir, lamivudine, and efavirenz). Subjects were examined, and a pre-tested questionnaire was used to collect data, including age, sex, comorbidity, history of disease, family history, treatment compliance, clinical profile, and laboratory parameters. Blood sample was taken among subjects using aseptic precautions for blood investigation, inflammatory markers, CD4, and lipid profile. Data was then entered into MS excel spreadsheet for analysis.

Low HDL (high-density lipoprotein) was the commonest lipid profile abnormality in PLWHA before ART and after ART. No significant correlation between WHO stage and CD4 count with altera­tion of lipids in both the groups was observed.

Significant number of patients showed improvement in inflammatory markers, more among those with recently added TLD regimen, which was evident due to normalization of ESR and CRP. Low HDL was the commonest lipid profile abnormality in PLWHA before ART and after ART.

Cohen J. HIV/AIDS. India slashes estimate of HIV-infected people. Science 2007; 317: 179-181.
Haissman JM, Vestergaard LS, Sembuche S, Erikstrup C, Mmbando B, Mtullu S, et al. Plasma cytokine levels in Tanzanian HIV-1-infected adults and the effect of antiretroviral treatment. J Acquir Immune Defic Syndr 2009; 52: 493-497.
Ananworanich J, Gayet-Ageron A, Le Braz M, Prasithsirikul W, Chetchotisakd P, Kiertiburanakul S, et al. CD4-guided scheduled treatment interruptions compared with continuous therapy for patients infected with HIV-1: results of the Staccato randomized trial. Lancet 2006; 368: 459-465.
Wolf K, Tsakiris DA, Weber R, Erb P, Battegay M; Swiss HIV Cohort Study. Antiretroviral therapy reduces markers of endothelial and coagulation activation in patients infected with human immunodeficiency virus type 1. J Infect Dis 2002; 185: 456-462.
Kim A, Dadgostar H, Holland GN, Wenby R, Yu F, Terry BG, et al. Hemorheologic abnormalities associated with HIV infection: altered erythrocyte aggregation and deformability. Invest Ophthalmol Vis Sci 2006; 47: 3927-3932.
Branson BM, Stekler JD. Detection of acute HIV infection: we can’t close the window. J Infect Dis 2012; 205: 521-524.
Amornkul PN, Karita E, Kamali A, Rida WN, Sanders EJ, Lakhi S, et al. Disease progression by infecting HIV-1 subtype in a seroconverter cohort in sub-Saharan Africa. AIDS 2013; 27: 2775-2786.
Rodríguez B, Sethi AK, Cheruvu VK, Mackay W, Bosch RJ, Kitahata M, et al. Predictive value of plasma HIV RNA level on rate of CD4 T-cell decline in untreated HIV infection. JAMA 2006; 296: 1498-1506.
Miranda-Fernandez C, Pulido F, Carrillo JL, Larumbe S, Gómez Izquierdo T, Ortuño B, et al. Lipoprotein alterations in patients with HIV infection: relation with cellular and humoral immune markers. Clin Chem Acta 1998; 274: 63-70.
Constans J, Pellegrin JL, Peuchant E, Dumon MF, Pellegrin I, Sergeant C, et al. Plasma lipids in HIV-infected patients: a prospective study in 95 patients. Eur J Clin Invest 1994; 24: 416-420.
Zangerle R, Sarcletti M, Gallati H, Reibnegger G, Wachter H, Fuchs D. Decreased plasma concentrations of HDL cholesterol in HIV-infected individuals are associated with immune activation. J Acquir Immune Defic Syndr (1988) 1994; 7: 1149-1156.
Shor-Posner G, Basit B, Lu Y, Cabrejos C, Chang J, Fletcher M, et al. Hypocholesterolemia is associated with immune dysfunction in early human immunodeficiency virus-1 infection. Am J Med 1993; 94: 515-519.
Owens RJ, Anantharamaiah GM, Kahion JB, Srinivas RV, Compans RW, Segrest J P. Apolipoprotein A1 and its amphipathic helix peptide analogues inhibit human immunodeficiency virus-induced syncytium formation. J Clin Invest 1990; 86: 1142-1150.
Feingold KR, Memon RA, Moser AH, Grunfeld C. Paraoxonase activity in the serum and hepatic mRNA levels decrease during the acute phase response. Atherosclerosis 1998; 139: 307-315.
McLemore JL, Beeley P, Thorton K, Morrisroe K, Blackwell W, Dasgupta A. Rapid automated determination of lipid hydroperoxide concentrations and the total antioxidant status of serum samples from patients infected with HIV: elevated lipid hydroperoxide concentrations and depleted total antioxidant capacity of serum samples. Am J Clin Pathol 1998; 109: 268-273.
Favier A, Sappey C, Leclerc P, Faure P, Micoud M. Antioxidant status and lipid peroxidation in patients infected with HIV. Chem Biol Interact 1994; 91: 165-180.
Sandstrom PA, Tebbey PW, Van Cleave S, Buttke TM. Lipid hydroperoxides induce apoptosis in T-cells displaying an HIV-associated glutathione peroxidase deficiency. J Biol Chem 1994; 269: 798-801.
McDonagh J, Fossel ET, Kradin RK, Dubinett SM, Laposata M, Hallaq YA. Effects of tumor necrosis factor-a on peroxidation of plasma lipoprotein lipids in experimental animals and patients. Blood 1992; 80: 3217-3226.
Baruchel S, Waimberg MA. The role of oxidative stress in individuals infected by the human immunodeficiency virus. J Leukocyte Biol 1992; 52: 111-114.
Hardardottir I, Grunfeld C, Feingold KR. Effects of endotoxin and cytokines on lipid metabolism. Curr Opin Lipidol 1994; 5: 207-215.
Feingold KR, Staprans I, Memon RA, Moser AH, Shigenaga JK, Doerrler W, et al. Endotoxin rapidly induces changes in lipid meta­bolism that produce hypertriglyceridemia: low doses stimulate hepatic triglyceride production while high doses inhibit clearance. J Lipid Res 1992; 33: 1765-1776.
Gouni I, Oka K, Etienne J, Chan L. Endotoxin induced hypertriglyceridemia is mediated by suppression of lipoprotein lipase at a post transcriptional level. J Lipid Res 1993; 34: 139-146.
Feingold KR, Memon RA, Moser AH, Shigenaga JK, Grunfeld C, et al. Endotoxin and interleukin-1 decrease hepatic lipase mRNA levels. Atherosclerosis 1999; 142: 379-387.
Jahoor F, Gazzard B, Phillips G, Sharpstone D, Delrosario M, Frazer ME, et al. The acute-phase protein response to human immunodeficiency virus infection in human subjects. Am J Physiol 1999; 276: E1092-E1098. DOI: 10.1152/ajpendo.1999.276.6.E1092.
Grunfeld C, Pang M, Doerrler W, Shigenaga JK, Jensen P, Feingold KR. Lipids, lipoproteins, triglyceride clearance, and cytokines in human immunodeficiency virus infection and the acquired immunodeficiency syndrome. J Clin Endocrinol Metab 1992; 74: 1045-1052.
Monnet D, Kacou E, Gershey Damet GM, Lonsdorfer A, Odehouri K, Yapo AE. Inflammatory reaction markers and nutritional markers in HIV Infection. Ann Biol Clin 1991; 49: 428-432.
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