Abstract
BackgroundCardiovascular disease (CVD) poses a significant cause of morbidity and mortality among people living with human immunodeficiency virus (HIV). However, data are limited on CVD risk burden among HIV patients in Ghana. We describe the age‐ and sex‐adjusted prevalence of CVD risk factors among HIV patients in Ghana.MethodsFrom January 2013 to May 2014, we identified eligible HIV patients 18 years and older, as well as uninfected adult blood donors presenting to the Komfo Anokye Teaching Hospital as controls. Using a standardized protocol, we collected demographic, clinical, laboratory, and electrocardiographic data. We created multivariable logistic regression models to compare the prevalence of abnormal risk factors between the two groups.ResultsWe recruited 345 patients with HIV (n = 173 on HAART, n = 172 not on HAART) and 161 uninfected adult blood donors. Patients with HIV were older (mean [SD] age: 41 [11] vs 32 [11] years) and were more likely to be female (72% vs 28%) than blood donors. Among patients on HAART, median (interquartile range) treatment duration was 17 (4‐52) months. The prevalence of hypertension, hypercholesterolemia, and diabetes mellitus among HIV patients was 9%, 29%, and 5%, respectively, compared with 5%, 15%, and 0.6% among uninfected blood donors. Smoking was the least prevalent CVD risk factor (1%‐2%). After adjustment for age, sex, and body mass index, HIV patients had a 10‐fold higher odds of prevalent diabetes compared with controls, (adjusted OR = 10.3 [95% CI: 1.2, 86.7]).ConclusionCVD risk factors are common among HIV patients in Ghana, demonstrating the urgent need for creation and implementation of strategic CVD interventions.
Highlights
Human immunodeficiency virus/ acquired immune deficiency syndrome (HIV/AIDS) is the leading cause of death in Africa accounting for 20% of mortality
human immunodeficiency virus (HIV)/AIDS, highly active antiretroviral therapy (HAART), and associated behaviors lead to 50% to 100% higher risk for Cardiovascular disease (CVD) among individuals living with HIV compared with the general population.[4,5]
Compared with patients with HIV on baseline HAART, patients with HIV not on HAART had a lower odds of hypercholesterolemia (17% vs 39%, adjusted OR = 0.4 [95% CI: 0.2, 0.7]) and abdominal obesity (11% vs 28%, adjusted OR = 0.4 [95% CI: 0.4, 0.8])
Summary
Human immunodeficiency virus/ acquired immune deficiency syndrome (HIV/AIDS) is the leading cause of death in Africa accounting for 20% of mortality. HIV prevalence is high: subSaharan Africa (SSA) has only 11% of the world's population, 70% of all adults with HIV live in SSA.[1] Antiretroviral therapy has substantially improved the prognosis for HIV-infected patients[2] with steadily declining HIV/AIDs-related deaths within SSA following the dramatic scaling up of antiretroviral therapy and other priority HIV/AIDS interventions since 2004.3 Amidst falling HIV incidence rates, people living with HIV are living longer and are exposed to risks for comorbid conditions, especially cardiovascular diseases (CVD). The combination of HIV and CVD has created an epidemic that is projected to surpass infectious disease alone as the leading cause of mortality in SSA by 20306 and presents a significant risk toward achieving the United Nations' Sustainable Development Goals 3.3 and 3.4 which aim to end the AIDS epidemic and to reduce the risk of premature deaths from noncommunicable diseases by one-third by 2030, respectively.[7]. The ultimate aim is to drive policy and practice reforms in universal access to comprehensive, accessible, and quality health services to reduce HIV-related morbidity and mortality
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