Blood Glucose Level and Serum Lipid Profiles among HIV-infected Patients on Dolutegravir-based Versus Efavirenz-based Combined Antiretroviral Therapy in Dessie Comprehensive Specialized Hospital, Northeast Ethiopia.

Abstract

Abstract Introduction: Antiretroviral therapy-linked metabolic abnormalities have become a growing concern among HIV patients due to their association with diabetes and cardiovascular disease risk. Currently, a dolutegravir-based regimen is a preferred first-line regimen. However, there is limited data regarding the effects of dolutegravir-based treatment on blood glucose level and serum lipid profiles of HIV patients in Ethiopia. Objectives: To assess blood glucose level and serum lipid profiles among HIV-infected patients on dolutegravir-based versus efavirenz-based combined antiretroviral therapy in Dessie Comprehensive Specialized Hospital, Northeast Ethiopia. Methods and materials: An institutional-based comparative cross-sectional study was conducted from June 30 to August 30/2021. An equal number of dolutegravir and efavirenztreated patients (n = 64 each) taking at least for six months and above were included, and a purposive sampling technique was used. Blood glucose level and serum lipid profiles were measured using Siemens Dimension EXL 200 System, clinical chemistry analyzer. For statistical analysis chi-square, independent t-test, Mann朩hitney U-test and logistic regression were used using SPSS Version 26. A P-value of <0.05 was considered statistically significant. Result: The prevalence of hyperglycemia and dyslipidemia were 11 (17.4%) and 51 (79.7%) in the dolutegravir group, and 6 (9.4%) and 48 (75%) in the efavirenz group, respectively. The efavirenz group had significantly higher mean values of total cholesterol (190.73�.13 vs 175.27�.67 mg/dl, p=0.035) and high-density lipoprotein (47.53�.25 vs 40.92�.17 mg/dl, p=0.007) than the dolutegravir group. There was statistically insignificant difference between the mean values of fasting blood sugar, low-density lipoprotein, and triglyceride in both groups. Body mass index (AOR= 1.45 95% CI: 1.08, 1.95) and duration of HIV infection (AOR= 1.13, 95% CI: 1.04-1.23) were associated with hyperglycemia, whereas being female (AOR = 3.04, 95% CI: 1.15, 8.05) and CD4 cell count (AOR = 1.003, 95% CI: 1.001, 1.006) were associated with dyslipidemia in HIV-infected patients on ART. Conclusion: Efavirenz resulted in higher mean values of total cholesterol and high-density lipoprotein as compared with dolutegravir. It is important to monitor and evaluate highdensity lipoprotein levels in HIV patients on dolutegravir-based therapy, as well as total cholesterol levels in HIV patients on efavirenz-based therapy. Keywords: Blood glucose level, serum lipid profiles, HIV, dolutegravir, efavirenz.