The prevalence of dyslipidemia in hiv infected children receiving highly active antiretroviral therapy at the Kenyatta National Hospital
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Date
2009Author
Mutisya, Kilonzo S
Type
ThesisLanguage
enMetadata
Show full item recordAbstract
Implementation of highly active antiretroviral therapy (HAART) has
resulted in decline in morbidity and mortality in HIV-infected children, with more
children living into adulthood. However, the long term adverse effects, including
dyslipidemia, have raised concern on increased cardiovascular risk in this population.
Objective: To determine the prevalence of dyslipidemia in HIV-infected children
receiving HAART at the Kenyatta National Hospital.
Study design: Hospital based Cross sectional study
Study methods: HIV-infected children on HAART aged between 18 months and 15
years were recruited. Demographic, clinical and immunologic data were recorded. The
United States National Cholesterol Education Programme III guidelines in children were
used to define dyslipidemia (Total cholesterol ≥ 5.17 mmol/l, triglycerides ≥ 1.69 mmol/l,
low density lipoprotein cholesterol ≥ 3.36 mmol/l and high density lipoprotein cholesterol
< 0.9 mmol/l). The prevalence of dyslipidemia was determined and associated factors
were explored.
Results: For a total of 170 patients analyzed, the prevalence of dyslipidemia was 40%
(95% CI, 18-36). The prevalence of hypercholesterolemia was 27.1% and prevalence of
hypertriglyceridemia 11.8%. High low density lipoprotein (LDL) cholesterol was
observed in 19.4% of the patients and low high density lipoprotein (HDL) cholesterol in
5.3%. The prevalence of dyslipidemia among patients on non-nucleoside reverse
transcriptase inhibitor based regimens was 37% compared to 90% in patients on protease
inhibitor based therapy. Factors found to be associated with the presence of dyslipidemia
were age 10 years and below (OR 3.2; 95% CI: 1.3 – 7.7, p = 0.009) and protease
inhibitor therapy (OR 7.5; 95% CI: 1.5 – 38.5, p = 0.015).
Conclusion: There is a high prevalence of dyslipidemia in HIV-infected children taking
HAART at the Kenyatta National Hospital Comprehensive Care Centre. There is need to
perform baseline lipid profiles in patients starting HAART and there after reassessment at
least every six months.
Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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