Serum Lipid Profiles of Patients Taking Efavirenz-Based Antiretroviral Regimen Compared to Ritonavir-Boosted Atazanavir with an Optimized Background at Zewditu Memorial Hospital, Addis Ababa, Ethiopia

Figures & data

Table 1 Baseline Characteristics of Study Participants at ART Clinic of ZMH, Addis Ababa, Ethiopia, 2018

Variables	EFV-Treated n=90	ATV/r-Treated n=90	p-value
Age, mean±SD	41.2±8.8	42.2±8.8	0.4
Sex, Female, n (%)	55 (61.1%)	52 (57.8%)	0.7
CD4+ count at enrolment(cell/mL), median (IQR)	454 (103–1655)	355 (40–1041)	0.002*
Viral load determined last 6 months, n (%)	39 (43.3%)	40 (44.4%)	0.7
Undetectable viral load (<50 copies/cell), n (%)	35 (89.7%)	30 (75%)	0.2
Months since first HIV diagnosis, median (IQR)	108 (16–164)	138 (35–240)	<0.001*
Months on HAART, median (IQR)	89 (15–163)	133 (34–174)	<0.001*
Months on current regimen, median (IQR)	48 (15–156)	25 (13–44)	<0.001*
Prophylaxis drugs for OIs, n (%)	12 (13.3)	12 (13.3)	1.0
Body mass index, mean±SD	25.0±4.2	24.3±4.4	0.2
<18, n (%)	4 (4.4%)	5 (5.6%)	0.6
18–24, n (%)	41 (45.6%)	48 (53.3%)
25–30, n (%)	35 (38.9%)	30 (33.3%)
>30, n (%)	10 (11.1%)	7 (7.8%)
Waist circumference
Male >cut-off value, n (%)	14 (40%)	15 (30.6%)	0.5
Female >cut-off value, n (%)	34 (61.8%)	24 (58.5%)	0.9
Waist-to-hip ratio
Male >cut-off value, n (%)	10 (28.6%)	5 (10.2%)	0.06
Female >cut-off value, n (%)	17 (30.9%)	8 (19.5%)	0.06
Physical exercise, n (%)	54 (60%)	50 (55.6%)	0.7
Alcohol drinking habit, n (%)	10 (11.1%)	4 (4.4%)	0.6

Notes: Continuous variables are reported as mean (SD) and median (IQR), categorical variables are reported as number and percentage; *Statistically significant.

Abbreviations: SD, standard deviation; IQR, interquartile range; EFV, efavirenz; ATV/r, ritonavir-boosted atazanavir; OIs, opportunistic infections; n, number; %, percentage.

Table 2 Lipid Levels Among Ethiopian, Adult HIV Patients Stratified by EFV/ATV/r and Sex, ZMH, Addis Ababa, Ethiopia, 2018

Lipid Profile	Categories	Total, N (%)	EFV, N (%)	ATV/r, N (%)	Female			Male
					Total	EFV, N (%)	ATV/r, N (%)	Total, N (%)	EFV, N (%)	ATV/r, N (%)
TC	>200 mg/dL, n (%)	52 (28.9)	26 (28.9)	26 (28.9)	28 (26.4)	12 (21.8)	16 (31.4)	24 (32.4)	14 (40)	10 (25.6)
	Mean (SD)	181.86±45.7	184.1±41.5	179.6±49.7	180.2±43.7	196.1±50.4	171.1±44.1*	184.2±48.5	176.4±32.8	189.7±54.5
HDL	<40 mg/dL, n (%)	82 (45.6)	35 (38.9)	47 (52.2)	42 (39.6)	20 (36.4)	22 (43.1)	40 (54.1)	15 (42.9)	25 (64.1)
	Mean (SD)	41.73±11.252	44.7±12.4	38.7±9.0*	43.02±12	42.4±10.6	37.8±9.3*	39.8±9.7	46.3±13.3	39.8±8.7*
TG	>200 mg/dL, n (%)	71 (39.4)	24 (26.7)	47 (52.2)*	29 (27.4)	6 (10.9)	23 (45.1)*	42 (56.8)	18 (51.4)	24 (61.5)
	Median (IQR)	169 (42–1,094)	145 (42–768)	207 (56–1,094)*	167.4±84.6	210 (71–768)	219 (56–1,094)	262.1±183.0	123 (42–768)	184 (71–481)*
LDL	>129 mg/dL, n (%)	90 (50)	49 (54.4)	41 (45.6)	52 (49.1)	27 (49.1)	25 (49)	38 (51.4)	22 (62.9)	16 (41)
	Mean (SD)	129.46±43.9	131.2±43.4	127.7±44.5	128.9±42.3	125.4±38.8	138.1±46.8	130.2±46.2	140.4±48.9	118.9±40.9*
TC/HDL	>5, n (%)	53 (29.4)	24 (26.7)	29 (32.2)
	Mean (SD)	4.598±1.6	4.4±1.5	4.8±1.6
TG/HDL	Mean (SD)	5.492±4.7	4.4±3.6	6.6±5.5*
LDL/HDL	Mean (SD)	3.25±1.24	3.1±1.2	3.4±1.2*

Note: *Statistically significant.

Abbreviations: N, number; %, percentage; TC, total cholesterol; HDL-C, high-density lipoprotein; LDL-C, low-density lipoprotein-cholesterol; TG, triglyceride; TC/HDL-C ratio, total cholesterol/high-density lipoprotein-cholesterol ratio; EFV, efavirenz; ATV/r, ritonavir-boosted atazanavir; IQR, interquartile range.

Table 3 Univariate and Multivariate Logistic Regression Analysis of TC and TG with the Independent Variables, Adult HIV Patients at ZMH, Addis Ababa, Ethiopia, 2018

Variables	Category	TC in mg/dL				TG in mg/dL
		<200	>200	COR (95% CI)	AOR (95% CI)	<200	>200	COR (95% CI)	AOR (95% CI)
Sex	Female	78	28	0.74 (0.39–1.433)		77	29	0.287 (0.153–0.537)*	0.269 (0.135–.536)**
	Male	50	24	1		32	42	1	1
Age	<40	68	26	0.882 (0.463–1.682)		56	38	1.090 (0.599–1.983)
	≥40	60	26	1		53	33	1
Regular Exercise	No	66	20	1.703 (0.883–3.287)		53	33	0.918 (0.504–1.670)
	Yes	62	32	1		56	38	1
CD4 count	<455	85	24	2.306 (1.195–4.449)*	2.227 (1.145–4.329)**	66	43	1.001 (0.543–1.844)
	≥455	43	28	1	1	43	28	1
Duration of HIV	<132	66	26	0.939 (0.493–1.79)		62	30	0.555 (0.303–1.015)
	≥132	62	26	1		47	41	1
Duration of ART	<123	64	26	1 (1.525–1.905)		62	28	0.494 (0.269–0.907)*	1.469 (0.744–2.901)
	≥123	64	26	1		47	43	1	1
Duration with the current ART	<36	79	31	1.092 (0.565–2.11)		58	52	2.407 (1.261–4.592)*	0.582 (0.27–1.255)
	≥36	49	21	1		51	19	1	1
Current ART	EFV	64	26	1 (1.525–1.905)		66	24	0.333 (0.178–.621)*	0.387 (0.173–0.867)**
	ATV/r	64	26	1		43	47	1	1
BMI	<25	74	21	0.494 (0.257–0.952)*	1.941 (0.997–3.779)	59	36	0.872 (0.479–1.586)
	≥25	54	31	1		50	35	1

Notes: *Statistically significant by univariate logistic regression; **statistically significant by multivariate logistic regression.

Abbreviations: TC, total cholesterol; TG, triglyceride; ART, antiretroviral therapy; BMI, body mass index; EFV, efavirenz; ATV/r, ritonavir-boosted atazanavir; COR, crude odds ratio; AOR, adjusted odds ratio; CI, confidence interval.

Table 4 Univariate and Multivariate Logistic Regression Analysis of LDL and HDL with the Independent Variables, Adult HIV Patients at ZMH, Addis Ababa, Ethiopia, 2018

Variables	Category	LDL in mg/dL				HDL in mg/dL
		<129	>129	COR (95% CI)	AOR (95% CI)	<40	>40	COR (95% CI)	AOR (95% CI)
Sex	Female	54	52	1	1	42	64	1	1
	Male	36	38	1.096 (0.605–1.985)	1.015 (0.536–1.922)	40	34	1.793 (0.983–3.268)	1.818 (0.948–3.485)
Age in years	<40	47	47	1	1	43	51	1	1
	≥40	43	43	1 (0.557–1.795)	0.939 (0.5–1.763)	39	47	0.984 (0.547–1.771)	1.044 (0.548–1.987)
Regular ex.	No	43	43	1		36	50	1
	Yes	47	47	1 (0.557–1.795)		46	48	1.331 (0.738–2.399)
CD4 count	<455	53	56	1	1	55	54	1	1
	≥455	37	34	0.87 (0.478–1.582)	0.654 (0.337–1.269)	27	44	0.602 (0.328–1.107)	0.663 (0.336–1.307)
Months since HIV+	<132	52	40	1	1	41	51	1	1
	≥132	38	50	1.711 (0.948–3.085)	2.784 (1.015–7.641)	41	47	1.085 (0.603–1.951)	0.213 (0.064–0.705)**
HAART duration	<123	48	42	1	1	33	57	1	1
	≥123	42	48	1.306 (0.727–2.346)	0.736 (0.276–1.965)	49	41	2.064 (1.137–3.749)*	6.305 (1.939–20.502)**
Current ART duration	<36	57	53	1	1	56	54	1	1
	≥36	33	37	1.206 (0.662–2.197)	1.054 (0.505–2.199)	26	44	0.57 (0.309–1.051)	0.647 (0.30–1.360)
Current ART	EFV	41	49	1	1	35	55	1	1
	ATV/r	49	41	0.7 (0.389–1.259)	0.564 (0.258–1.233)	47	43	1.718 (0.95–3.105)	1.468 (0.676–3.184)
BMI	<25	60	35	1	1	35	60	1	1
	≥25	30	55	3.143 (1.708–5.782)*	3.128 (1.668–5.869)**	47	38	2.12 (1.167–3.852)*	2.632 (1.375–5.036)**

Notes: *Statistically significant by univariate logistic regression; **statistically significant by multivariate logistic regression.

Abbreviations: TC, total cholesterol; TG, triglyceride; ART, antiretroviral therapy; BMI, body mass index; EFV, Efavirenz; ATV/r, ritonavir-boosted atazanavir; COR, crude odds ratio; AOR, adjusted odds ratio; CI, confidence interval.