Juma Kenneth, Nyabera Roseanne, Mbugua Sylvia, Odinya George, Jowi James, Ngunga Mzee, Zakus David, Yonga Gerald
African Population and Health Research Center, Nairobi, Kenya; Clinical Epidemiology Unit, School of Medicine, Makerere University, Kampala, Uganda. Email:
Cardiac Programme Coordination Unit, the Mater Hospital, Nairobi, Kenya.
Cardiovasc J Afr. 2019;30(1):52-56. doi: 10.5830/CVJA-2018-064. Epub 2019 Jan 24.
To determine the prevalence of cardiovascular risk factors and their association with antiretroviral therapy (ART) among HIV-infected adults in a rural sub-county hospital in Kenya.
This was a descriptive survey of patient charts characterising cardiovascular risk among adult patients (> 18 years) at Ukwala sub-county hospital between June 2013 and January 2015. Post-stratification survey weights were applied to obtain prevalence levels. Adjusted odds ratios (AOR) for each variable related to cardiovascular risk factors were calculated using logistic regression models.
Overall, the prevalence of diabetes mellitus was 0.4%, 0.3% of patients had had a previous cardiovascular event (heart attack or stroke), 40.4% had pre-hypertension, while 10.4% had stage 1 and 2.9% stage 2 hypertension. Up to 14% of patients had elevated non-fasting total cholesterol levels. Factors associated with hypertension were male gender (AOR 1.59, = 0.0001), being over 40 years of age (AOR 1.78, = 0.0001) and having an increased waist circumference (OR 2.56, = 0.0014). Raised total cholesterol was more likely in those on tenofovir disoproxil fumarate (TDF) (AOR 2.2, p = 0.0042), azidothymidine (AZT) (AOR 2.5, = 0.0004) and stavudine (D4T) -containing regimens (AOR 3.13, = 0.0002).
An elevated prevalence of undiagnosed cardiovascular risk factors such as hypertension and raised total cholesterol levels was found among people living with HIV. There was an association between raised total cholesterol and nucleoside reverse-transcriptase inhibitor (NRTI) -based ART regimens. Our findings provide further rationale for integrating routine cardiovascular risk-factor screening into HIV-care services.
确定肯尼亚一个农村次县级医院中感染艾滋病毒的成年人中心血管危险因素的患病率及其与抗逆转录病毒疗法（ART）的关联。
这是一项对2013年6月至2015年1月期间Ukwala次县级医院成年患者（>18岁）心血管风险特征的患者病历进行的描述性调查。采用分层后调查权重来获得患病率水平。使用逻辑回归模型计算与心血管危险因素相关的每个变量的调整比值比（AOR）。
总体而言，糖尿病患病率为0.4%，0.3%的患者曾发生过心血管事件（心脏病发作或中风），40.4%患有高血压前期，而10.4%患有1期高血压，2.9%患有2期高血压。高达14%的患者非空腹总胆固醇水平升高。与高血压相关的因素包括男性（AOR 1.59，p = 0.0001）、年龄超过40岁（AOR 1.78，p = 0.0001）以及腰围增加（OR 2.56，p = 0.0014）。服用富马酸替诺福韦二吡呋酯（TDF）（AOR 2.2，p = 0.0042）、齐多夫定（AZT）（AOR 2.5，p = 0.0004）和含司他夫定（D4T）方案的患者总胆固醇升高的可能性更大（AOR 3.13，p = 0.0002）。
在艾滋病毒感染者中发现未诊断出的心血管危险因素如高血压和总胆固醇水平升高的患病率较高。总胆固醇升高与基于核苷类逆转录酶抑制剂（NRTI）的抗逆转录病毒疗法方案之间存在关联。我们的研究结果为将常规心血管危险因素筛查纳入艾滋病毒护理服务提供了进一步的理论依据。
