A STUDY TO ASSESS ANTHROPOMETRIC PARAMETERS AND SERUM LIPID VARIATIONS IN HIV PATIENTS RECEIVING HAART

Background:- There is evidence that ART is associated with lipodystrophy syndrome, a disturbance of lipid metabolism characterised by insulin resistance, dyslipidaemia and fat maldistribution, usually presenting as visceral abdominal obesity and cervical fat pad accumulation (buffalo hump)1,metabolic bone disease (osteopenia and/or osteoporosis) and lactic acidosis. ART- associated dyslipidaemia is characterized by elevated serum concentrations of total cholesterol, triglycerides, low density lipoprotein 2(LDL-c), very low-density lipoprotein (VLDL), Apo lipoprotein B (apoB) and low levels of high density lipoprotein (HDL-c) constituting an atherogenic lipid profile2. Materials And Methods:- In this study 100 young patients who were attending the Antiretroviral Therapy Plus Centre & Medicine Wards, ACSR GMC, NELLORE were included randomly. Anthropometric Measurement :- Body weights were measured (to the nearest 0.5 kilogram) with the subject standing on a weighing scale after it was adjusted to zero kg. Heights were measured (to the nearest 1.0 centimeter) with the subject standing in an erect position against a vertical scale of portable standiometer and a L-square placed on the head and the head positioned to a level with the inferior margin of the bony orbit. The waist measurements were taken from the middle point between the iliac crest and the last rib as recommended by the WHO. Hip circumference was measured as the maximal circumference over the buttocks. BMIs were then calculated as weight in kilograms divided by the height in meter squared. Results:- The results of the study showed that the Anthropometric parameters on analysis showed a normal range BMI in 59% of patients. Waist-to-hip ratio which have been shown to be better reflector of body fat distribution and is significantly elevated in the HIV-infected patients on HAART. Waist-Hip ratio value analysis showed normal in 18.19% and abnormal in 81.81% of cases. The mean value in males is 0.9578 and in females is 0.9204. This showed a significant correlation to Waist/ hip ratio and the gender. Conclusions:- Significant metabolic and morphological alterations occur in HIV infected patients especially in patients on HAART. The patients on HAART had an elevated Castelli Index I, indicating an increased risk for atherosclerotic cardiovascular disease in this population. Waist-to-hip ratio which are the key indices for assessing body fat distribution were significantly raised in HAART-experienced patients in this study implying that HAART could result to lipodystrophy.