PhD Research Seeks to Improve HIV Anti-retroviral Treatment

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Dr Raadhiya Osman graduated with a PhD in Health Sciences following her study titled: Prevalence of Metabolic Syndrom and Lipodystrophy in HIV-Positive Patients on Anti-retroviral Therapy attending Addington Hospital.

Supervised by Dr Peter Owira, Osman investigated the prevalence of and the factors associated with the development of Metabolic Syndrome (MS) and lipodystrophy in people with HIV on antiretroviral therapy (ART) at the Ikusasa Clinic located at Addington Hospital in Durban, KwaZulu-Natal. This cross-sectional retrospective study was based on patient interviews and review of records of 350 patients. Structured questionnaires and data collection forms were used to collect data on demographic, socio-economic, lifestyle, clinical and laboratory investigation.

Osman said the beginning of combination anti-retroviral treatment (cART)- which refers to the combination of drugs are used to keep HIV infections under control - brought about significant improvements in the survival and quality of life of HIV-infected patients as well as a dramatic decrease in the incidence of opportunistic infections. ‘However, metabolic abnormalities and abnormal fat distribution in people on cART have been reported elsewhere, yet not much of it is known in South Africa,’ she continued. She said these metabolic complications and abnormal fat redistribution syndromes were a risk for type 2 diabetes and cardiovascular disease complications. 

Regimen 1a (lamivudine, tenofivir and efavirenz), Regimen 1b (lamivudine, tenofivir and nevirapine), Regimen 2 (didanosine, zidovudine and lopinavir/ritonavir), Fixed Dose Combination (FDC-comprising of tenofovir, emtricitabine and efavirenz) and Modified Regimen (doses of tenofivir adjusted due to renal abnormalities) are used at Addington Hospital. ‘Factors associated with the occurrence of Metabolic Syndrome and lipodystrophy were female gender, Regimen 2, smoking, race, high BMI and duration of treatment. Regimen 2 contains Protease Inhibitors (PIs), thus indicating that it contributes to MS as previously reported. These findings suggest that patients on antiretroviral treatment with risk factors should be monitored regularly for MS and lipodystrophy in order to avoid predisposition to diabetes cardiovascular diseases,’ cautioned Osman, adding that the study will assist clinicians with the prescribing of antiretroviral treatment.

Osman is busy with a Primary care drug therapy (PCDT) course for pharmacists. ‘This allows pharmacists to become more clinically involved with their patients,’ she said, adding, ‘My family is extremely excited and grateful that I have completed my PhD as my children need more quality time with their mother.’

Words: Nombuso Dlamini 

Photograph: Rajesh Jantilal