J Appl Biomed 19:73-82, 2021 | DOI: 10.32725/jab.2021.002

Contributory role of ART in the development of non-AIDS comorbidities in asymptomatic PLWHA

Karen Ingrid Tasca^{1, *}, Vânia V. M. Fagundes Vidal², Vanessa Martinez Manfio³, Alexandre Naime Barbosa^2,3, Lenice do Rosário de Souza^2,3

¹ São Paulo State University - UNESP, Institute of Biosciences of Botucatu, Department of Microbiology and Immunology, Botucatu, São Paulo State, Brazil

² Specialist Outpatient Service for Infectious Diseases "Domingos Alves Meira" (SAEI-DAM), Botucatu, São Paulo State, Brazil

³ São Paulo State University - UNESP, Botucatu Medical School, Department of Tropical Diseases and Imaging Diagnosis, Botucatu, São Paulo State, Brazil

Background: Despite the many benefits that follow antiretroviral therapy (ART) initiation, its chronic use contributes to the early aging of people living with HIV/AIDS (PLWHA). The aim of this cross-sectional study was to trace the prevalence of and investigate possible renal, bone and metabolic changes, as well as cardiovascular risk in 94 asymptomatic PLWHA, relating them to the duration of ART use.

Methods: Four groups were evaluated according to ART use: G1 (n = 21), ART-naïve individuals; G2 (n = 17), <2 years; G3 (n = 40), 2-10 years; and G4 (n = 16) on ART for more than 10 years.

Results: Our results showed a high prevalence of dyslipidemic individuals (64%), especially in those under ART. Lower creatine phosphokinase levels were observed in G1 as compared to the others (p < 0.05). Regarding the Framingham score, 12.1% of PLWHA showed moderate and high risk, and the highest proportion (38.5%) occurred in G4 (p = 0.003). A decrease in glomerular filtration rates occurred in 20% of patients, which was also more significant in G3 and G4 (p = 0.007). High prevalences of osteopenia and osteoporosis (53.2%) were found, especially in G1 and G4; however, G1 showed the lowest means for alkaline phosphatases (AP, p = 0.04 and BAP, p = 0.005) and osteocalcin (p = 0.005), in addition to higher vitamin-D concentrations (p = 0.04).

Conclusions: Our study showed the possible contributory role of ART in these changes, which leads us to reflect on the need for specific conducts and patient care, pointing out the importance of individualized care in an attempt to increase life expectancy.

Keywords: Antiretroviral; Dyslipidemia; HIV, Aids; Non-AIDS comorbidities

Grants and funding:

São Paulo Research Foundation, Brazil (FAPESP, Proc. 2016/15440- 4) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES).

Conflicts of interest:

The authors declare that they have no conflicts of interest.

Received: April 27, 2020; Revised: December 22, 2020; Accepted: January 21, 2021; Prepublished online: January 27, 2021; Published: March 3, 2021  Show citation