Internal Medicine, The Aga Khan University Hospital Nairobi, Nairobi, Kenya.
Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya.
BMJ Open. 2022 Jun 6;12(6):e062352. doi: 10.1136/bmjopen-2022-062352.
To determine the prevalence of cardiovascular disease (CVD) risk factors and explore associations with high-sensitivity cardiac troponin I (hscTnI) and high-sensitivity C-reactive protein (hsCRP) in people living with HIV (PLHIV) in Kenya.
Pilot cross-sectional study.
Data were collected from community HIV clinics across two sites in Nairobi, Kenya, from July 2019 to May 2020.
Convenience sample of 200 PLHIV (≥30 years with no prior history of CVD).
Prevalence of cardiovascular risk factors and its association with hsTnI and hsCRP levels.
Across 200 PLHIV (median age 46 years, IQR 38-53; 61% women), the prevalence of hypercholesterolaemia (total cholesterol >6.1 mmol/L) and hypertension were 19% (n=30/199) and 30% (n=60/200), respectively. Smoking and diabetes prevalence was 3% (n=5/200) and 4% (n=7/200). HscTnI was below the limit of quantification (<2.5 ng/L) in 65% (n=109/169). High (>3 mg/L), intermediate (1-3 mg/L) and low (<1 mg/L) hsCRP levels were found in 38% (n=75/198), 33% (n=65/198) and 29% (n=58/198), respectively. Framingham laboratory-based risk scores classified 83% of PLHIV at low risk with 12% and 5% at intermediate and high risk, respectively. Older age (adjusted OR (aOR) per year increase 1.05, 95% CI 1.01 to 1.08) and systolic blood pressure (140-159 mm Hg (aOR 2.96; 95% CI 1.09 to 7.90) and >160 mm Hg (aOR 4.68, 95% CI 1.55 to 14) compared with <140 mm Hg) were associated with hscTnI levels. No associations were observed between hsCRP and CVD risk factors.
The majority of PLHIV-using traditional risk estimation systems-have a low estimated CVD risk likely reflecting a younger aged population predominantly consisting of women. Hypertension and hypercholesterolaemia were common while smoking and diabetes rates remained low. While hscTnI values were associated with increasing age and raised blood pressure, no associations between hsCRP levels and traditional cardiovascular risk factors were observed.
确定肯尼亚艾滋病毒感染者（PLHIV）心血管疾病（CVD）风险因素的流行情况，并探讨其与高敏心肌肌钙蛋白 I（hscTnI）和高敏 C 反应蛋白（hsCRP）的关系。
试点横断面研究。
数据来自肯尼亚内罗毕两个地点的社区 HIV 诊所，于 2019 年 7 月至 2020 年 5 月期间收集。
便利样本 200 名 PLHIV（年龄≥30 岁，无 CVD 既往史）。
心血管风险因素的流行情况及其与 hsTnI 和 hsCRP 水平的关系。
在 200 名 PLHIV 中（中位数年龄 46 岁，IQR 38-53；61%为女性），高胆固醇血症（总胆固醇>6.1mmol/L）和高血压的患病率分别为 19%（n=30/199）和 30%（n=60/200）。吸烟和糖尿病的患病率分别为 3%（n=5/200）和 4%（n=7/200）。65%（n=109/169）的 hscTnI 低于检测限（<2.5ng/L）。高（>3mg/L）、中（1-3mg/L）和低（<1mg/L）hsCRP 水平分别在 38%（n=75/198）、33%（n=65/198）和 29%（n=58/198）中发现。Framingham 实验室基于风险评分将 83%的 PLHIV 归类为低风险，12%和 5%分别为中风险和高风险。年龄较大（每增加 1 岁的调整比值比（aOR）为 1.05，95%CI 1.01 至 1.08）和收缩压（140-159mmHg（aOR 2.96；95%CI 1.09 至 7.90）和>160mmHg（aOR 4.68，95%CI 1.55 至 14）与<140mmHg）与 hscTnI 水平相关。hsCRP 与 CVD 风险因素之间未观察到相关性。
使用传统风险评估系统的大多数 PLHIV-具有较低的估计 CVD 风险，这可能反映了一个以年轻女性为主的人群。高血压和高胆固醇血症很常见，而吸烟和糖尿病的发病率仍然较低。尽管 hscTnI 值与年龄增长和血压升高有关，但未观察到 hsCRP 水平与传统心血管风险因素之间的相关性。
