Global cardiovascular risk of the HIV-positive patients under antiretroviral therapy in Brazzaville

Abstract

To contribute to the improvement of the assumption of responsibility of the people living with the HIV under antiretroviral therapy (ART) by the evaluation of their global cardiovascular risk. The study was a cross-sectional one, carried out from January to August 2015 at the Brazzaville Ambulatory Processing Center and at the National Centre of Blood Transfusion. The studied variables were related to the epidemiologic, clinical and biological aspects (glycemia, serum rates of total cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol). The global cardiovascular risk was evaluated by the scores of Framingham and the WHO/ISH. They were 135 HIV-positive subjects including 64 treaties by ART. The subjects were divided into 83 men (61.5%) and 52 women (38.5%). The average age was 42.6 ± 2.9 years, without difference between the two sexes. The subjects were single people (62.2%), of an educational level secondary (63,7%), and civil servants (32.6%). The found independent factors of risk were a dyslipidemia (60%), obesity (36%), tobacco addiction (12.6%), arterial hypertension (5.9%), diabetes mellitus (0.7%). The metabolic syndrome was found in seven cases (11.3%). The global cardiovascular risk according to the score of Framingham, initially moderated at 18% of the subjects, and mean at 2%, was average at 9% and high at 2% of the subjects respectively in the sixth month of treatment ( P < 0.03). For the score of the WHO/ISH, the risk was high at 1.4% and very high at 2.8% initially. This risk was high at 3% and very high at 3.1% of the subjects in the sixth month of treatment ( P < 0.05). In Congo, the HIV infection touches a relatively young population. This vulnerable population involves a global cardiovascular high risk under antiretroviral therapy. Preventive actions are highly recommended.