Atherogenic Risk Indices as Predictors of Cardiovascular Disease in HIV Patients Receiving Highly Active Antiretroviral Therapy in a Nigerian Tertiary Hospital

Abstract

Human immunodeficiency virus (HIV) infection remains a significant global health challenge. While the introduction of highly active antiretroviral therapy (HAART) has greatly improved survival and quality of life, it has also been associated with metabolic complications, including dyslipidaemia and increased cardiovascular risk. This study aimed to evaluate lipid profiles and cardiovascular risk markers among HIV-positive patients receiving treatment at Rivers State University Teaching Hospital (RSUTH), Port Harcourt, Nigeria. A total of 150 participants were enrolled, comprising 90 HIV-positive individuals on HAART and 60 HIV-negative controls. Blood samples were collected and analyzed for total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) using standard enzymatic methods. Cardiovascular risk indices, including Castelli’s Risk Index I (CRI-I), Castelli’s Risk Index II (CRI-II), Atherogenic Index of Plasma (AIP), and Atherogenic Coefficient (AC), were subsequently calculated. Data were analyzed using SPSS version 23, with statistical significance set at p < 0.05. Results revealed that HIV-positive participants had significantly higher mean levels of total cholesterol (6.27 ± 0.51 mmol/L), triglycerides (2.28 ± 0.34 mmol/L), and non-HDL cholesterol (5.30 ± 0.61 mmol/L) compared with controls, while LDL-C levels were lower (0.97 ± 0.18 mmol/L). Additionally, atherogenic indices (CRI-I, CRI-II, AIP, and AC) were markedly elevated among HIV-positive individuals, particularly in older adults and smokers. In conclusion, HIV-positive patients receiving HAART exhibit an increased burden of dyslipidaemia and cardiovascular risk. These findings highlight the importance of routine lipid monitoring and comprehensive cardiovascular risk assessment in the management of HIV to reduce long-term therapy-related complications.