1. Title Verdana Bold 72pt Introduction Results Methods
Serum levels of Lipoprotein(a) in HIV positive patients on HAART at Livingstone Central Hospital, Livingstone, Southern Province, Zambia.
Corresponding author: Sepiso K. Masenga, University of Zambia School of Medicine:
Title Verdana
Bold 72pt
Sepiso k Masenga1,2 Trevor Kaile2 and Timothy Kantenga3
1. Ministry of Health, Livingstone Central Hospital, Livingstone , Zambia. 2.University of Zambia, School of medicine, Department of Pathology & Microbiology, Lusaka, Zambia. 3. University Teaching Hospital, Department of Pathology & Microbiology, Lusaka, Zambia.
Ministry of Health
Introduction
Results
Lipoprotein(a) concentration mean was 0.86 µmol/L ± 0.45µmol/L. Prevalence of high
Lipoprotein(a) was 31.5% of which 29.4% and 2.1% were in the high risk and very high risk for CVD categories respectively. There was a significant relationship between age (p=0.009), duration on HAART (p<0.001) and high Lipoprotein(a) levels.
Lipoprotein(a) is a highly atherogenic independent risk marker for Cardiovascular
disease (CVD) and current studies have shown that Highly Active Antiretroviral Therapy
(HAART) raises Lipoprotein(a) levels in HIV patients, thereby increasing their risk for CVD.
However, Lipoprotein(a) distribution varies by populations and ethnicity due to its highly
regulated genetic predisposition. In this study, Lipoprotein(a) distribution in HIV patients on
HAART were determined as well as their risk category for CVD based on their Lipoprotein(a)
Concentration levels.
Figure 3: Participant’s risk category for developing cardiovascular disease based on their
Lipoprotein(a) serum concentration levels
Methods
We conducted a cross sectional descriptive study between December 2014 and February 2015 at Livingstone Central Hospital where fasting serum samples were collected and sent to the University Teaching Hospital Biochemistry laboratory for analysis. The Demographic
and clinical data from patient files collected were age, gender, ART combination and duration on ART. For data analysis, STATA version 12.0 and SPSS version 17.0 were used.
The Study sample comprised of 57 (39.9%) males and 86 (60.1%) females who had been on
HAART from one to ten years.
Risk category for developing a CVD using a Lipoprotein(a) conc. threshold of 0.50µmol/L
Figure 2: High and low Lipoprotein(a) concentration
level in Short and Longer duration on HAART
Figure 1: High and low Lipoprotein(a) in different age categories
Discussion/Conclusions
We showed from our study for the first time, the burden of high Lipoprotein(a) in HIV positive individuals in a Zambian population. Since Lipoprotein(a) tended to be raised with increasing age (p=0.009) and longer duration on HAART (p <0.001), this implies that age and duration on HAART could be risk factors for CVD associated with High Lp(a). However, high Lp(a) does not necessarily indicate Clinical CVD risk as many factors would have to be considered such as apo(a) size isoform, SNPs, Copy number variation in Lp(a) etc, which were not measured in this study. Important to also mention, a limiting factor to our study was a reduced sample size, hence, we could not generalize these results to the general population. Considering what other authors have published, we have in addition, from our study, provided empirical evidence that high Lipoprotein(a) is a metabolic complication of HAART.
Future research implications
A prospective study addressing polymorphisms in the Lipoprotein(a) and Interleukin 6 genes with their concomitant serum levels and inflammatory markers is being planned for. The study aims to showcase new perspectives in the metabolic complications of HIV disease and treatment as well as address the role of dietary lifestyle. The Corresponding author together with other experts will be responsible for its inception.