High Prevalence of Hypocholesterolaemia among Antiretroviral Therapy-naive HIV-infected Children in Makurdi, Nigeria: A Retrospective Study

Aim: To determine the abnormalities in total cholesterol (TC) levels and the potential risk factors in ART–naive, HIV-infected Nigerian children.
Study Design: A retrospective and cross-sectional study.
Place and Duration of Study: Paediatric antiretroviral therapy (ART) clinic of the Federal Medical Centre, Makurdi, between June 2010 and June 2012.
Methods: Electronic data of 429 HIV-infected ART-naive children, aged 1–15 years, including 223 males and 206 females, were analysed to get the relevant information for the study. Abnormal un-fasted TC levels and the association with potential risk factors were tested in bivariate regression analyses. Abnormal lipid level was defined as hypercholestrolaemia when the TC was>200mg/dL and hypocholesterolaemia when TC was Ë‚160mg/dl. Normal TC was value between 160 and 200mg/dl. P-value less than 0.05 was significant.
Results: The median age was 5.00 years with an interquartile range of 3.0 to 8.0 years. The TC ranged from 32 to 196 mg/dl with a mean value of 116±34.98mg/dl. Hypocholesterolaemia was the prominent finding in 88.3% (379/429) of the children. Hypercholestrolaemia was not found (0%). In bivariate analyses, no factor was found to significantly impact on hypocholesterolaemia, although a greater proportion of hypocholesterolaemia was seen in children: within 2-15 years age group (92.1%, 349/379); male gender (52.0%): HIV/AIDS stages 1&2 (82.6%); CD4 count>200 cell/mm3(81.5%); viral load>10,000 copies/ml (69.1%); hemoglobinË‚10g/dl (61.7%); stunting (55.4%, 102/207) and undernourishment with body mass index (BMI)Ë‚18.5 (83.7%, 164/222). Multivariate analysis was not done.
Conclusion: A high prevalence of hypocholesterolaemia was found among the ART-naive, HIV-infected Children, in Makurdi. The study could serve as a stimulus for our centre and other paediatric ART programmes in Nigeria to undertake an elaborate lipid profile of HIV infected children at diagnosis and on follow-up on ART.