Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Kwame Nkrumah University of Science & Technology, School of Medicine and Dentistry, Kumasi, Ghana.
Clin Cardiol. 2019 Dec;42(12):1195-1201. doi: 10.1002/clc.23273. Epub 2019 Sep 30.
Cardiovascular 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.
From 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.
We 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]).
CVD risk factors are common among HIV patients in Ghana, demonstrating the urgent need for creation and implementation of strategic CVD interventions.
心血管疾病(CVD)是导致艾滋病毒(HIV)感染者发病和死亡的主要原因。然而,有关加纳 HIV 患者 CVD 风险负担的数据有限。我们描述了加纳 HIV 患者 CVD 风险因素的年龄和性别调整患病率。
2013 年 1 月至 2014 年 5 月,我们确定了符合条件的 18 岁及以上 HIV 患者,以及作为对照的未感染成年献血者。使用标准化方案,我们收集了人口统计学、临床、实验室和心电图数据。我们创建了多变量逻辑回归模型,以比较两组之间异常风险因素的患病率。
我们招募了 345 名 HIV 患者(HAART 组 173 名,未接受 HAART 组 172 名)和 161 名未感染的成年献血者。与献血者相比,HIV 患者年龄较大(平均[标准差]年龄:41[11] vs 32[11]岁),更可能为女性(72% vs 28%)。在接受 HAART 的患者中,中位数(四分位距)治疗时间为 17(4-52)个月。与未感染的献血者相比,HIV 患者高血压、高胆固醇血症和糖尿病的患病率分别为 9%、29%和 5%,而未感染的献血者分别为 5%、15%和 0.6%。吸烟是 CVD 风险因素中最不常见的(1%-2%)。在调整年龄、性别和体重指数后,与对照组相比,HIV 患者的糖尿病患病率高出 10 倍,(调整后的 OR = 10.3 [95%CI:1.2,86.7])。
加纳 HIV 患者 CVD 风险因素很常见,迫切需要制定和实施战略性 CVD 干预措施。