Original Research

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

Wilhelm P. Greffrath, Jesslee M. du Plessis, Michelle Viljoen, Marike Cockeran
Southern African Journal of HIV Medicine | Vol 19, No 1 | a766 | DOI: https://doi.org/10.4102/sajhivmed.v19i1.766 | © 2018 Wilhelm P. Greffrath, Jesslee M. Du Plessis, Michelle Viljoen, Marike Cockeran | This work is licensed under CC Attribution 4.0
Submitted: 22 May 2017 | Published: 26 June 2018

About the author(s)

Wilhelm P. Greffrath, KwaZulu-Natal Department of Health, South Africa
Jesslee M. du Plessis, Medicine Usage in South Africa (MUSA), North-West University, South Africa
Michelle Viljoen, Centre 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 Cape, South Africa
Marike Cockeran, Medicine Usage in South Africa (MUSA), North-West University, South Africa


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Abstract

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.


Keywords

Hypertriglyceridaemia; pancreatitis; lopinavir/ritonavir; cardiovascular risk

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