Annie Phoebe Kalyanasundaram, Saramma Mini Jacob, Hemalatha Ramachandran and Mampakkam Rajappa Sivakumar
Objective: Adiponectin is a plasma protein with anti-inflammatory and anti-atherogenic effects. Low levels of circulating adiponectin have been reported in HIV-infected patients. However, there are no studies in India on adiponectin levels in HIV-infected antiretroviral-treated and treatment-naïve subjects. Therefore, we estimated adiponectin levels in HIV-positive individuals and investigated their associations with antiretroviral therapy (ART) and lipid profile.
Materials and methods: Consenting HIV-infected and non-infected men and women were recruited from Namakkal district, Tamilnadu, India. A semi structured questionnaire was administered in the local language (Tamil) to all patients which included socio-demographics, and details on ART. Fasting blood samples were collected and anthropometric measurements obtained. Serum adiponectin levels and lipid profile levels were determined.
Results: Adiponectin levels were measured in 139 individuals of whom sixty four individuals were on ART, 36 were ART naïve, and 39 were HIV-negative subjects. HIV-infected patients had significantly lower adiponectin levels than the HIV-uninfected (p=0.000). HIV-positive patients had a 17.92-fold decrease in adiponectin values when compared to HIV-negative controls. Also, patients on ART had a 21-fold decrease in adiponectin levels when compared to ARTnaïve patients. Moreover, patient’s currently or previously receiving stavudine treatment had a 3.8-fold decrease in adiponectin levels when compared to those who had never received stavudine. Regarding lipid profile, high density lipoprotein (HDL) - cholesterol was positively associated with adiponectin (p=0.004) while very low density lipoprotein (VLDL) - cholesterol (p=0.017) and triglycerides (p=0.017) showed a negative association in patients on ART. Adiponectin concentration in patients on ART with dyslipidemia was significantly decreased as compared to those without dyslipidemia (p=0.030).
Conclusion: Serum adiponectin levels were lower in this HIV-infected South Indian population as compared to HIVnegative controls. Stavudine seemed to influence adiponectin levels. The significant association between ART-induced hypoadiponectinemia and adverse changes in lipid profile suggests a higher risk of atherosclerosis in this population.
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