Serum Leptin Levels in Antiretroviral Therapy Naïve HIV-1 Infected Patients in Zaria, Nigeria

Background:This study aimed at determining serum leptin levels in ART naïve HIV-1 infected adults in relation to body mass index (BMI), CD4 cell count and presence or absence of symptomatic HIV disease or features of AIDS. Materials & Methods: This cross sectional study was undertaken in 2008 among patients, attending Ahmadu Bello University Teaching Hospital. Serum leptin levels by ELISA were determined in 40 consecutive sex matched, HIV infected adults (20 normal weight and 20 underweight) and 26 sex matched HIV negative, healthy, normal weight controls. Symptomatic and asymptomatic HIV infected patients as well as AIDS and non-AIDS patients with similar BMI were compared. CD4 cell counts were correlated with leptin levels. Results: The median leptin levels of healthy controls and asymptomatic normal weight patients were not significantly different. Female patients tended to have lower leptin values than male ones. Median leptin was lower in underweight patients when compared to normal weight patients (13.8 vs 39ng/mL, p=0.009) and also lower in symptomatic patients when compared to asymptomatic patients (27.9 vs 43.9ng/mL, p=0.038) but not significantly different between AIDS and non-AIDS cases. Among healthy controls, leptin levels positively correlated with CD4 T counts (r=0.47, p=0.04) but in HIV/AIDS patients the correlation (r=0.28, p=0.07) was not significant. Conclusion: In wasted HIV infected patients, low leptin levels were reflective of loss of adipose mass and were worse in females. It is suggested that independent of the effect of BMI, leptin secretion is down regulated in untreated symptomatic HIV/AIDS patients with secondary infections. The results also suggest that the nor-mal leptin induced rise with CD4 T cell counts may be blunted by untreated HIV infection.