Atherogenic Index of Plasma and High-Sensitivity C-Reactive Protein Levels Among People Living With HIV on Dolutegravir and Ritonavir-Boosted Atazanavir-Based Antiretroviral Therapy and Their Correlations to CD4 Cell Counts.

Abstract

Background: Atherogenic index of plasma (AIP) and high-sensitivity C-reactive protein (hsCRP) levels which are strong predictors of the risk of cardiovascular disease (CVD) seen elevated in the serum of people living with HIV (PLWH) on HAART and in those with low cluster of differentiation-4 (CD4) cell counts. Thus, this study aimed to evaluate AIP and hsCRP levels among PLWH on dolutegravir (DTG) and ritonavir-boosted atazanavir-based (ATV/r) antiretroviral therapy (ART) and their correlations to CD4 cell counts. Methods: The study design was an institutional-based comparative cross-sectional study conducted from November 4, 2021, to January 4, 2022. The total sample size was 172 with equal number of DTG and ritonavir-boosted atazanavir-treated PLWH. Participants were recruited by a consecutive sampling method. The data were entered into EpiData Version 4.6, then exported to SPSS Version 25.0, and analyzed using Chi-square, Student's t-test, and Pearson correlation. Statistical significance was set at p < 0.05. Results: AIP was significantly higher among individuals on ATV/r, with levels in the range of 0.1-0.24 at 44.2% and > 0.24 at 31.4%, compared with those on DTG-based regimens of ART, which showed levels of 39.5% and 9.3%, respectively. Similarly, the higher hsCRP level of ≥ 2 mg/L was observed among patients on ATV/r (44.2%) than in DTG-based (24.4%) regimens of ART. AIP and hsCRP were negatively correlated with CD4 cell counts with Pearson correlation coefficients of -0.46 and -0.38, respectively. Conclusion: From the study conducted, it can be concluded that the higher levels of AIP and hsCRP were seen in patients treated by ATV/r than in DTG-based regimens of ART and in PLWH with low CD4 cell counts. Therefore, routine monitoring of both AIP and hsCRP levels was a good marker of HIV disease progression and cardiovascular disease risk assessment in PLWH, particularly in developing countries where CD4 cell count testing is expensive and not easily available.