Effect of antiretroviral therapy on cardiac risk markers in people living with HIV/AIDS

Introduction: Chronic HIV infection and antiretroviral therapy (ART) are the major causes of cardiovascular diseases (CVDs) and mortality in HIV patients. This study was conducted to look upon the effect of ART on CVD risk markers in patients on different ART regimens and ART-naive patients. Methods: It was a cross-sectional, observational study done on 120 HIV-infected patients. CV risk markers were assessed and correlated with disease-specific factors within individual subgroups differentiated as Group A (ART naive), Group B (first-line ART), and Group C (second-line ART). Carotid intimal medial thickness (CIMT) and high-sensitivity C reactive protein (hsCRP) were done to classify cases as having CVD. Results: CVD risk parameters were found to be significantly higher in cases on ART, as compared to ART-naive cases. The mean CIMT among cases in Group C, Group B, and Group A was 0.072 +/- 0.01 cm, 0.063 +/- 0.01 cm, and 0.055 +/- 0.01 cm, respectively (P < 0.01). 95%, 65% and 25% cases in Group C, Group B, and Group A, respectively, had high CIMT (> 0.06 cm) and were seen to be directly correlated with disease-related factors, i.e., duration of disease and ART, type of ART, and low CD4 cell counts. hsCRP was significantly increased in 65 out of total 120 cases. The mean hsCRP in Group A, Group B, and Group C was 3.69 +/- 3.37, 4.21 +/- 3.4, and 5.72 +/- 3.54 mg/L, respectively (P < 0.01), which corresponds to the high risk of CVD. Conclusion: CVD risk parameters of CIMT and hsCRP are seen to be higher in patients on ART than ART-naive subjects.