Castelli Risk Index, Atherogenic Index of Plasma, and Atherogenic Coefficient: Emerging Risk Predictors of Cardiovascular Disease in HIV-Treated Patients

Atherogenic cardiovascular risk assessment is important in the management of dyslipidaemia associated with antiretroviral therapy (ART). Generally, Castelli’s Risk Index (CRI), Atherogenic Index of Plasma (AIP) and Atherogenic coefficient (AC) are becoming useful indices as risk predictors for cardiovascular disease (CVD). We studied the importance of these indices in identifying at-risk HIV individuals receiving treatment. Eighty (80) HIV-patients comprising treatment (n=40) and treatment- na？ve (n=40) groups with age- and sex-matched were enrolled. Traditional lipid parameters {Total cholesterol (TC), Triglycerol (TG), and HDLc} were analyzed using spectrophotometry. The LDLc was calculated using Friedewald equation. Non-HDLc, CRI-I (TC/HDLc ratio) and CRI-II (LDLc/HDLc ratio), AIP {Log10 (TG/HDL-c)} and AC {(Non-HDLc)/ HDLc} were also calculated. The CD4+ cell count was determined using flow cytometry. The correlations between atherogenic indices and lipid profile were determined using Pearson’s correlation. P<0.05 was considered as significant. Risk estimation by stratification based on number of altered lipid profile parameter showed no significant increase (P>0.05) in any of the traditional lipid profile parameters except for HDLc with significant elevation (P<0.001) across the strata. Remarkably, all estimated atherogenic indices were found significantly high (P<0.001) across the strata. However, these indices showed positive significant correlations with LDLc and nonHDLc (p<0.001), but negative significant correlations with HDLc (p<0.01). In this present study, the estimated risk indices were suggestive of atherogenicity that helped identifying individuals with dyslipidemia at risk of CVD. Findings from this study also indicated that without markedly deranged lipid profile these estimated indices could serve as more sensitive risk predictors