Médecins Sans Frontières, Chiradzulu.
Queen Elizabeth Central Hospital, Blantyre, Malawi.
AIDS. 2018 Jan 14;32(2):253-260. doi: 10.1097/QAD.0000000000001700.
Data on cardiovascular disease risks among HIV-infected patients taking antiretroviral therapy (ART) over long periods of time are lacking in Sub-Saharan Africa.
A cross-sectional study was conducted in Chiradzulu, Malawi from December 2015 to June 2016. HIV-infected persons on ART for more than 10 years (patients) and HIV-negative individuals (controls) from selected clinics participated. Following informed consent, a standardized questionnaire, clinical and laboratory examinations were performed. The prevalence of cardiovascular disease risk factors was calculated and stratified by age group.
Overall, 379 HIV-infected patients and 356 controls participated. Median time on ART among patients was 11.6 years (interquartile range 10.6-12.4).Within the 30-44, 45-59, and at least 60-year age groups, respectively, the prevalence of hypertension was 10.8, 20.4, and 44.7% among patients and 6.1, 25.8, and 42.9% among controls. Hypertension was previously undiagnosed in 60.3% patients and 37.0% controls with elevated blood pressure. The prevalence of diabetes within the respective age groups was 5.0, 6.4, and 13.2% among patients, and 3.4, 4.2, and 1.7% among controls. HIV-infected patients were more likely to have an glycated hemoglobin at least 6.0% (adjusted odds ratio 1.9; 95% confidence interval 1.1-3.2, P = 0.02). Prevalence of low-density lipoprotein cholesterol more than 130 mg/dl within the respective age groups was 8.0, 15.4, and 23.7% among patients and 1.8, 12.5, and 11.8% among controls.
Noncommunicable diseases were a significant burden in Malawi, with high prevalence of hypercholesterolemia in all survey participants and an especially acute diabetes burden among older HIV infected. Hypertension screening and treatment services are needed among identified high-risk groups to cover unmet needs.
在撒哈拉以南非洲地区，缺乏接受抗逆转录病毒疗法（ART）治疗超过长时间的艾滋病毒感染者的心血管疾病风险数据。
2015 年 12 月至 2016 年 6 月在马拉维 Chiradzulu 进行了一项横断面研究。来自选定诊所的接受 ART 治疗超过 10 年的艾滋病毒感染者（患者）和艾滋病毒阴性个体（对照组）参与了研究。在获得知情同意后，对参与者进行了标准化问卷调查、临床和实验室检查。计算了心血管疾病危险因素的患病率，并按年龄组进行分层。
总体而言，379 名艾滋病毒感染者患者和 356 名对照组参与了研究。患者接受 ART 的中位时间为 11.6 年（四分位间距 10.6-12.4）。在 30-44、45-59 和至少 60 岁年龄组中，患者的高血压患病率分别为 10.8%、20.4%和 44.7%，对照组分别为 6.1%、25.8%和 42.9%。高血压在未接受诊断的患者中占 60.3%，在血压升高的对照组中占 37.0%。在相应的年龄组中，患者的糖尿病患病率为 5.0%、6.4%和 13.2%，对照组为 3.4%、4.2%和 1.7%。与对照组相比，糖化血红蛋白至少 6.0%的 HIV 感染者患者更有可能（调整后的优势比 1.9；95%置信区间 1.1-3.2，P=0.02）。在相应的年龄组中，低密度脂蛋白胆固醇超过 130mg/dl 的患者患病率为 8.0%、15.4%和 23.7%，对照组为 1.8%、12.5%和 11.8%。
在马拉维，非传染性疾病是一个重大负担，所有调查参与者的高胆固醇血症患病率都很高，而年龄较大的 HIV 感染者的糖尿病负担尤其严重。需要在确定的高风险人群中提供高血压筛查和治疗服务，以满足未满足的需求。
