Evaluation of Serum Lipid Profile and Apolipoprotein E Levels in HIV Infected Individuals with Malaria Infection in Nauth, Nnewi, Nigeria

Background: Human immunodeficiency virus (HIV) and malaria co-infection represents a significant public health challenge in sub-Saharan Africa, with both diseases independently affecting lipid metabolism and cardiovascular health. This study evaluated serum lipid profiles and apolipoprotein E (ApoE) levels in HIV-infected individuals with concurrent malaria infection. Methods: A comparative cross-sectional study was conducted at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria, involving 88 participants (38 females, 50 males) aged 18-65 years, stratified into four distinct groups: healthy controls (n=22), malaria only (n=22), HIV only (n=23), and HIV-malaria co-infection (n=22). Lipid profiles were determined using colorimetric enzymatic methods, while ApoE levels were measured by enzyme-linked immunosorbent assay. Malaria diagnosis was confirmed using rapid diagnostic tests and Giemsa-stained blood films. Statistical analysis employed one-way ANOVA, independent t-tests, and bivariate correlation. Results: ApoE levels were significantly lower in HIV-only (1.06±0.22 mg/dL) and co-infected groups (0.96±0.13 mg/dL) compared to controls (1.23±0.36 mg/dL) and malaria-only groups (1.38±1.02 mg/dL). Total cholesterol and triglycerides were significantly elevated in HIV-only (4.73±0.54 mmol/L; 1.24±0.47 mmol/L) and co-infected groups (4.97±0.63 mmol/L; 1.22±0.33 mmol/L). HDL cholesterol was significantly reduced in HIV and co-infected groups compared to controls. CD4 counts were significantly higher in HIV-only versus co-infected participants (817.58±304.15 vs. 630.98±247.73 cells/mm³, p=0.024). Significant positive correlations were observed between ApoE and HDL cholesterol (r=0.522, p=0.009) and BMI and triglycerides (r=0.478, p=0.018) in the co-infected group. Conclusion: HIV infection and HIV-malaria co-infection are associated with significant alterations in lipid metabolism and reduced ApoE levels, potentially increasing cardiovascular disease risk in affected individuals.