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Les dyslipidémies et antirétroviraux chez les personnes vivant avec le VIH dans le service de médecine interne au CHU-Tokoin de Lomé
Abstract
Objectives: Estimate the frequency of the dyslipidemia at the persons alive with the HIV (PVVIH) under antiretroviral treatment (ARV).
Methodology: It is acts from a transverse descriptive study to internal medicine in the CHU (Tokoin Teaching Hospital) - Tokoin of Lome over 12 months (in January 1st, 2010 - December 31st, 2010). The patient PVVIH follow-up in the department under ARV for more than 06 months was included in our study, having had a normal rate of lipid before the beginning of the treatment ARV. As soon as the patient returned for his balance assessment) of follow-up the results of which were noted in a pad of care. Our study consisted in finding and in analyzing the data following ones The age, the sex, the weight, the size, the type of HIV, the rate of CD4, the cholesterol level (total, HDL, LDL) and the triglyceridemy, the type of treatment(processing) ARV. The sampling of blood for analyses were made in the same laboratory, the 12 hours of fast before the taking for the dosage of lipids were respected. The test of khi2 was used to compare the frequencies.
Results: The analysis showed that 493 PVVIH was retained whose average duration under ARV was of 10 months. The mean age of the patients was 38.8 +/-10.9 the years and the extremes from 16 to 74 years old. The age brackets from 30 to 39 years and from 40 to 49 were the most represented, two (02) associated slices (edges) represented more than 70 % of the patients. The female genital organ was dominant with one sex-ratio in 0.28 (386 women against 107 men). On 493 PVVIH, 490 were infected by the typical HIV I, two (02) by the type II one (01) patient had two types of HIV. 78 % with a rate of CD4 < 500 ml. 55% had a normal IMC (18-25), 22% an overweight IMC (25-30) 9% a moderated obesity IMC (30-35), 5% a morbid obesity IMC upper to 35. 428 patients (86,8%) were under tritherapies consisted of 2 nucleosidic inhibitors of the inverse transcriptase (INT) + 1 inhibitor not nucleosidic Of the inverse transcriptase (INNT) and 65 patients (13.2%) under 2 INT+1inhibiteur of the protéase (IP). In plan of the lipid biology, the hypercholesterol level, hyper LDL-cholesterolemy, the hypo HDLcholesterolemy were respectively found at 41.4%, 23.5% and 17.4% of the patients. The difference is not significant between the frequencies of the lipid disorders at the patients under plans understanding the INNT and those containing the IP.
Conclusion: The disorders of the lipid metabolism exist in this population (persons alive with the HIV under antiretroviral treatment in Lome). The frequency of these disorders does not differ as the patient is under a tritherapy understanding the inhibitors of protease or not.
Keywords: Antiretrovirals, HIV, dyslipidémies, Lome
J. Rech. Sci. Univ. Lomé (Togo), 2012, Série D, 14(1) : 45-49
Methodology: It is acts from a transverse descriptive study to internal medicine in the CHU (Tokoin Teaching Hospital) - Tokoin of Lome over 12 months (in January 1st, 2010 - December 31st, 2010). The patient PVVIH follow-up in the department under ARV for more than 06 months was included in our study, having had a normal rate of lipid before the beginning of the treatment ARV. As soon as the patient returned for his balance assessment) of follow-up the results of which were noted in a pad of care. Our study consisted in finding and in analyzing the data following ones The age, the sex, the weight, the size, the type of HIV, the rate of CD4, the cholesterol level (total, HDL, LDL) and the triglyceridemy, the type of treatment(processing) ARV. The sampling of blood for analyses were made in the same laboratory, the 12 hours of fast before the taking for the dosage of lipids were respected. The test of khi2 was used to compare the frequencies.
Results: The analysis showed that 493 PVVIH was retained whose average duration under ARV was of 10 months. The mean age of the patients was 38.8 +/-10.9 the years and the extremes from 16 to 74 years old. The age brackets from 30 to 39 years and from 40 to 49 were the most represented, two (02) associated slices (edges) represented more than 70 % of the patients. The female genital organ was dominant with one sex-ratio in 0.28 (386 women against 107 men). On 493 PVVIH, 490 were infected by the typical HIV I, two (02) by the type II one (01) patient had two types of HIV. 78 % with a rate of CD4 < 500 ml. 55% had a normal IMC (18-25), 22% an overweight IMC (25-30) 9% a moderated obesity IMC (30-35), 5% a morbid obesity IMC upper to 35. 428 patients (86,8%) were under tritherapies consisted of 2 nucleosidic inhibitors of the inverse transcriptase (INT) + 1 inhibitor not nucleosidic Of the inverse transcriptase (INNT) and 65 patients (13.2%) under 2 INT+1inhibiteur of the protéase (IP). In plan of the lipid biology, the hypercholesterol level, hyper LDL-cholesterolemy, the hypo HDLcholesterolemy were respectively found at 41.4%, 23.5% and 17.4% of the patients. The difference is not significant between the frequencies of the lipid disorders at the patients under plans understanding the INNT and those containing the IP.
Conclusion: The disorders of the lipid metabolism exist in this population (persons alive with the HIV under antiretroviral treatment in Lome). The frequency of these disorders does not differ as the patient is under a tritherapy understanding the inhibitors of protease or not.
Keywords: Antiretrovirals, HIV, dyslipidémies, Lome
J. Rech. Sci. Univ. Lomé (Togo), 2012, Série D, 14(1) : 45-49
