Prevalence and factors associated with dyslipidemia among adult patients on dolutegravir based antiretroviral regimen at Mengo Hospital, A cross-sectional study

Abstract

Introduction: Dolutegravir (DTG) based anti-retroviral therapy (ART) regimen has been rolled out in Uganda as the preferred first- and second-line treatment option in the management of Human Immunodeficiency Virus (HIV). However, emerging evidence from studies suggests a high incidence of dyslipidemia associated with the use of DTG in developed countries. This poses a great risk factor for both non-communicable and cardiovascular diseases. It was important to understand the burden of dyslipidemia and its associated factors among adults on DTG based ART regimen in our setting.

Objectives: To elucidate the magnitude and factors associated with dyslipidemia among adult patients on DTG based ART regimen in Mengo Hospital in order to improve on the treatment outcomes of these patients.

Methods: A cross-sectional study was conducted between July 2022 and August 2022 on adults attending routine care at the counselling and home care department (CHCD) of Mengo Hospital. A total of 341 systematically sampled adults on DTG based ART regimen for more than 6 months who met the eligibility criteria were enrolled into the study. A pretested questionnaire was used to collect data on participants’ socio-demographic, clinical, behavioral characteristics and other variables including blood pressure, weight and height were measured. Laboratory measurements including fasting lipid profile and fasting blood glucose levels were also measured. Data was entered into EpiData 4.6 and analyzed with STATA 14.

Results: The prevalence of dyslipidemia was 78.0%, (95%CI 73.3 - 82.1). The highest prevalence was for low high-density lipoprotein (HDL) 72.1%, (95%CI 67.1 - 76.7) followed by high triglycerides (TG) 20.2%, (95%CI 16.3 - 24.9), high total cholesterol (TC) 12.0%, (95%CI 9.0 - 15.9) and high low-density lipoprotein (LDL) 6.5 %, (95%CI 4.3 - 9.6). Female sex (aPR:1.5, 95%CI 1.27 - 1.77, p<0.001), previous protease inhibitor (PI) based ART regimen (aPR:1.27, 95%CI 1.05 - 1.52, p=0.012) and being single (aPR:1.13, 95%CI 1.02 - 1.52, p=0.017) were significantly associated with dyslipidemia.

Conclusion: The prevalence of dyslipidemia was very high with more than three quarters of the study participants having the disorder. Female sex, previous PI based ART regimen and being single were associated with dyslipidemia. Further research should be done to understand whether there is a temporal relationship between dyslipidemia and DTG among ART patients.