Lipidemia status and associated factors among HIV positive adult male on HAART attending the HIV Clinic At Kericho District Hospital Kericho, Kenya
Bor, Wesley Kipkorir
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It is unfortunate that while Highly Active Antiretroviral Therapy (HAART) has become the standard of care among HIV positive patients, the medications have been associated with metabolic abnormalities recognized to cause lipidemia. The purpose of this cross sectional analytical study (n=310) was to establish lipidemia status and associated factors among HIV positive adult male patients attending HIV clinic at Kericho District Hospital. Purposive sampling was used to select the study hospital and study subject by gender. Systematic sampling was used to select study samples (n=310) and sub sample for 24 hour recall (n=155). A structured questionnaire was used to collect data on the social, demographic, economic, cultural, 24 hour recall, and anthropometric. Lipid profile assessment was performed on fasting blood sample using standard automated procedures (Cobas Mira Plus-Roche, USA). Physical activity was assessed using a physical activity questionnaire. A measure of central tendency was carried out for demographic, social and economic data. Anthropometric data analysis involved the display of mean and standard deviation of calculated BMI and skin fold measurement. Biochemical analysis was done through measure of central tendency with proportion for LDL, HDL, triglycerides and total cholesterols. 24 hour recall was analyzed for mean nutrient consumption for key nutrients and the 7 day recall was analysed for food frequency. Physical activity data was analyzed for mean and standard deviations. Analysis of variance was used to assess the significance of study parameters between body fat percentage and dietary pattern, lipid profile and HAART classification. Student t test was used to analyse correlations between the body composition values for LDL and the Skin fold measurements (%).The results indicated that the mean age was 43.52 ± 9.17 years and out of which 82.27% were married. Primary Education level attained 40.97% while secondary level was 45.16%. The mean lipid profile level was LDL 2.5 ± 1.05mmol/l, cholesterol 4.49 mmol/L ± 1.28 mmol/l, HDL 1.47± 0.58 mmol/l and triglycerides 1.96 ± 1.32 mmol/l, against the expected level of LDL (1.1.-2.4 mmol/L),HDL (0.9- 1.68 mmol/L ) triglyceride (0.41-2.61 mmol/L ) and total cholesterol ( 2.55-5.7 mmol/L).The prevalence lipidemia was 48.17% with mean difference of 2.5 for PI and non PI based regimen. Normal nutritional status was 70.97%. Mean dietary intake for macronutrients was energy (2049 ± 302), Protein (60 ± 24), cholesterol (249 ± 246), PUFA (5 ± 5), Fat (47 ± 20) and Fibres was (27 ± 16). Mean intake of key micro nutrients was Vitamin A (928±144), Vitamin B1 (1±0.5), Folic acid (336±64), Zinc (11 ± 4), Iron (9 ± 5), Magnesium (537 ± 341) and Vitamin C (50 ± 28). The findings showed that the mean LDL was elevated with proportion of lipidemia at a significant higher level among HIV-positive adult patients on HAART with considerable improvement in the nutritional status. A significant proportion of the respondents had basic education and in stable relationship. Diet diversification remains a significant challenge. Future work should investigate the biological mechanisms and pathways through which micronutrients affects high density lipoprotein (HDL) and low density lipoproteins (LDL).