Dyslipidemia among HIV-positive children receiving antiretroviral therapy in Indonesia

Introduction
Antiretroviral (ARV) therapy has changed the status of human immunodeficiency virus (HIV) infection from a high-mortality disease into a chronic one. One of the consequences of long-term use of ARV medications is dyslipidemia, which may progress to cardiovascular disease in the future. The aim of the study was to measure the rate of dyslipidemia among HIV-infected children receiving ARV therapy and related risk factors.

Material and methods
A cross-sectional study was conducted at pediatric outpatient clinic, Cipto Mangunkusumo Hospital, Jakarta, Indonesia, from January to July 2019. Lipid profile was examined on 96 eligible subjects and data regarding nutritional status, clinical stage at diagnosis, latest immunosuppression status, latest viral load (VL) value, and latest ARV combination used were obtained from medical records. Bivariate and multivariate analysis were performed to find the association between dependent and independent variables using SPSS version 22.

Results
Of 96 subjects included, 52 (54.2%) subjects experienced dyslipidemia. The prevalence of dyslipidemia among those with second-line (containing protease inhibitors) and first-line (containing non-nucleoside reverse transcriptase inhibitors) ARV therapy were 80% and 39%, respectively. The use of second-line ARV therapy was associated with 6.3 times (p < 0.01; 95% CI: 2.4-17.1) increased risk of dyslipidemia compared to first-line ARV therapy.

Conclusions
Prevalence of dyslipidemia among HIV-positive children on ARV was high with second-line ARV therapy being a risk factor.