Hypertriglyceridaemia and the risk of pancreatitis six months post lopinavir/ritonavir initiation

Background: Hypertriglyceridaemia (HTG) is an important risk factor for pancreatitis and cardiovascular disease (CVD), depending on severity. Hypertriglyceridaemia is common in human immunodeficiency virus (HIV) infection and is also a common complication of lopinavir/ritonavir (LPV/r). Objectives:...

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Main Authors: Wilhelm P. Greffrath, Jesslee M. du Plessis, Michelle Viljoen, Marike Cockeran
Format: Article
Language:English
Published: AOSIS 2018-06-01
Series:Southern African Journal of HIV Medicine
Subjects:
Online Access:https://sajhivmed.org.za/index.php/hivmed/article/view/766
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author Wilhelm P. Greffrath
Jesslee M. du Plessis
Michelle Viljoen
Marike Cockeran
author_facet Wilhelm P. Greffrath
Jesslee M. du Plessis
Michelle Viljoen
Marike Cockeran
author_sort Wilhelm P. Greffrath
collection DOAJ
description Background: Hypertriglyceridaemia (HTG) is an important risk factor for pancreatitis and cardiovascular disease (CVD), depending on severity. Hypertriglyceridaemia is common in human immunodeficiency virus (HIV) infection and is also a common complication of lopinavir/ritonavir (LPV/r). Objectives: To evaluate the risk of pancreatitis associated with HTG in patients six months post initiation of LPV/r-based therapy in a regional public hospital. Methods: Triglyceride (TG), serum amylase (s-amylase) and CD4+ count values were retrospectively investigated six months post LPV/r-based initiation. Age, gender, previous antiretroviral regimen and period since HIV diagnosis were also recorded. Results: The final sample consisted of 194 patients, 50 males and 144 females; mean (± standard deviation [s.d.]) age was 39.52 (± 9.98) years, and the mean (± s.d.) period since HIV diagnosis was 91.32 (± 25.18) months. Normal TG levels (< 1.70 mmol/L) were detected in only 55% of patients and the rest presented with some degree of HTG. The mean (± s.d.) TG for the entire sample was elevated at 1.94 (± 1.30) mmol/L with the mean (± s.d.) of the males at 2.36 (± 1.74) – statistically higher compared to the females at 1.79 (± 1.08) mmol/L (p = 0.034). No cases of pancreatitis were recorded and the time since HIV diagnosis did not indicate any statistically significant differences in the means of the TG, serum amylase or CD4 count values. Conclusion: Triglyceride levels were not substantially elevated to induce pancreatitis at six months post initiation of LPV/r, but were elevated above the accepted upper normal limit of 1.70 mmol/L which may have implications for cardiovascular risk.
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spelling doaj.art-e5c6a36f948b4da7ad4b33675785eb622022-12-22T00:47:11ZengAOSISSouthern African Journal of HIV Medicine1608-96932078-67512018-06-01191e1e610.4102/sajhivmed.v19i1.766590Hypertriglyceridaemia and the risk of pancreatitis six months post lopinavir/ritonavir initiationWilhelm P. Greffrath0Jesslee M. du Plessis1Michelle Viljoen2Marike Cockeran3KwaZulu-Natal Department of HealthMedicine Usage in South Africa (MUSA), North-West UniversityCentre of Excellence for Pharmaceutical Sciences, Division of Pharmacology, Faculty of Health Sciences, North-West University, South Africa; Pharmacology and Clinical Pharmacy, School of Pharmacy, Faculty of Natural Sciences, University of the Western CapeMedicine Usage in South Africa (MUSA), North-West UniversityBackground: Hypertriglyceridaemia (HTG) is an important risk factor for pancreatitis and cardiovascular disease (CVD), depending on severity. Hypertriglyceridaemia is common in human immunodeficiency virus (HIV) infection and is also a common complication of lopinavir/ritonavir (LPV/r). Objectives: To evaluate the risk of pancreatitis associated with HTG in patients six months post initiation of LPV/r-based therapy in a regional public hospital. Methods: Triglyceride (TG), serum amylase (s-amylase) and CD4+ count values were retrospectively investigated six months post LPV/r-based initiation. Age, gender, previous antiretroviral regimen and period since HIV diagnosis were also recorded. Results: The final sample consisted of 194 patients, 50 males and 144 females; mean (± standard deviation [s.d.]) age was 39.52 (± 9.98) years, and the mean (± s.d.) period since HIV diagnosis was 91.32 (± 25.18) months. Normal TG levels (< 1.70 mmol/L) were detected in only 55% of patients and the rest presented with some degree of HTG. The mean (± s.d.) TG for the entire sample was elevated at 1.94 (± 1.30) mmol/L with the mean (± s.d.) of the males at 2.36 (± 1.74) – statistically higher compared to the females at 1.79 (± 1.08) mmol/L (p = 0.034). No cases of pancreatitis were recorded and the time since HIV diagnosis did not indicate any statistically significant differences in the means of the TG, serum amylase or CD4 count values. Conclusion: Triglyceride levels were not substantially elevated to induce pancreatitis at six months post initiation of LPV/r, but were elevated above the accepted upper normal limit of 1.70 mmol/L which may have implications for cardiovascular risk.https://sajhivmed.org.za/index.php/hivmed/article/view/766Hypertriglyceridaemiapancreatitislopinavir/ritonavircardiovascular risk
spellingShingle Wilhelm P. Greffrath
Jesslee M. du Plessis
Michelle Viljoen
Marike Cockeran
Hypertriglyceridaemia and the risk of pancreatitis six months post lopinavir/ritonavir initiation
Southern African Journal of HIV Medicine
Hypertriglyceridaemia
pancreatitis
lopinavir/ritonavir
cardiovascular risk
title Hypertriglyceridaemia and the risk of pancreatitis six months post lopinavir/ritonavir initiation
title_full Hypertriglyceridaemia and the risk of pancreatitis six months post lopinavir/ritonavir initiation
title_fullStr Hypertriglyceridaemia and the risk of pancreatitis six months post lopinavir/ritonavir initiation
title_full_unstemmed Hypertriglyceridaemia and the risk of pancreatitis six months post lopinavir/ritonavir initiation
title_short Hypertriglyceridaemia and the risk of pancreatitis six months post lopinavir/ritonavir initiation
title_sort hypertriglyceridaemia and the risk of pancreatitis six months post lopinavir ritonavir initiation
topic Hypertriglyceridaemia
pancreatitis
lopinavir/ritonavir
cardiovascular risk
url https://sajhivmed.org.za/index.php/hivmed/article/view/766
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AT michelleviljoen hypertriglyceridaemiaandtheriskofpancreatitissixmonthspostlopinavirritonavirinitiation
AT marikecockeran hypertriglyceridaemiaandtheriskofpancreatitissixmonthspostlopinavirritonavirinitiation