Ajayi Oluseye Ayodele, Okonkwo Prosper, Ojo Temitope Olumuyiwa, Ajayi Oluwaseun Kikelomo, Ogunsola Olabanjo, Osayi Emmanuel, Onwuatuelo Ifeyinwa, Samuels Jay Osi
APIN Public Health Initiatives, Plot 1551, Zone E, Apo Resettlement, Apo, Abuja, Nigeria.
Program Department, APIN Public Health Initiatives, Headquarter Office, Abuja, Nigeria.
Ther Adv Infect Dis. 2024 Oct 18;11:20499361241289800. doi: 10.1177/20499361241289800. eCollection 2024 Jan-Dec.
Understanding the time to hypertension occurrence after antiretroviral treatment (ART) initiation in people living with HIV (PLHIV) and its determinants is important for designing interventions for control.
This study sought to estimate the median time of ART use to hypertension onset and its predictors in Nigerian PLHIV.
A retrospective longitudinal study.
This retrospective review of 2503 normotensive adult PLHIV (⩾18 years) from 2004 to 2020 in two HIV clinics in Nigeria. Incident hypertension was based on clinical diagnosis or two consecutive blood pressure readings ⩾140/90 mmHg, taken during the 8 months of data collection. Survival event was defined as incident hypertension during follow-up or interview day for observed patients unless they were right censored. The Kaplan-Meier survival curve was used to estimate the survival probabilities of hypertension. The Cox proportional hazard model was fitted to identify predictors of hypertension at < 0.05.
A total of 2503 PLHIV was followed up. The majority were females (74.6%) and on Dolutegravir-based therapy (93.0%). About 22 (0.9%) were diabetic. Median age at ART initiation was 35 (interquartile range: 29-41) years. The median period of follow-up was 12.0 ± 3.9 years. The cumulative incidence of hypertension was 32.5% (381/2540), with an incidence rate of 40.1/1000 person-years. The median time to incident hypertension was 17.0 years (95% CI: 12.5-21.5 years). Shorter hypertension-free survival times were seen in males, those aged 60+, with diabetes, unsuppressed viral load, history of tuberculosis, other opportunistic infections, or co-trimoxazole use. Significant risk factors included male sex (adjusted odds ratio (AOR) = 1.3, 95% CI = 1.1-1.6), middle age (AOR = 2.3, 95% CI = 1.7-3.2), old age (AOR = 5.6, 95% CI = 3.9-8.4), and unsuppressed viral load (AOR = 1.9, 95% CI = 1.3-2.7).
Hypertension is commoner among PLHIV with unsuppressed viral load, males, and persons older than 40 years. Effective ART with viral suppression remains essential. Incorporating regular hypertension screening and treatment into HIV care is necessary for optimum health outcomes.
了解艾滋病毒感染者（PLHIV）开始抗逆转录病毒治疗（ART）后发生高血压的时间及其决定因素对于设计控制干预措施很重要。
本研究旨在估计尼日利亚PLHIV开始使用ART至高血压发病的中位时间及其预测因素。
一项回顾性纵向研究。
对2004年至2020年期间在尼日利亚两家艾滋病毒诊所的2503名血压正常的成年PLHIV（≥18岁）进行回顾性研究。确诊高血压基于临床诊断或在8个月的数据收集期间连续两次血压读数≥140/90 mmHg。生存事件定义为观察患者在随访期间或访谈日发生的高血压，除非他们被右删失。采用Kaplan-Meier生存曲线估计高血压的生存概率。采用Cox比例风险模型确定高血压的预测因素，P<0.05。
共随访2503名PLHIV。大多数为女性（74.6%），接受基于多替拉韦的治疗（93.0%）。约22名（0.9%）患有糖尿病。开始ART时的中位年龄为35岁（四分位间距：29 - 41岁）。中位随访时间为12.0±3.9年。高血压的累积发病率为32.5%（381/2540），发病率为40.1/1000人年。发生高血压的中位时间为17.0年（95%CI：12.5 - 21.5年）。男性、60岁以上者、患有糖尿病者、病毒载量未被抑制者、有结核病病史者、有其他机会性感染或使用复方新诺明者的无高血压生存时间较短。显著的危险因素包括男性（调整优势比（AOR）=1.3，95%CI=1.1 - 1.6）、中年（AOR=2.3，95%CI=1.7 - 3.2）、老年（AOR=5.6，95%CI=3.9 - 8.4）和病毒载量未被抑制（AOR=1.9，95%CI=1.3 - 2.7）。
在病毒载量未被抑制的PLHIV、男性和40岁以上人群中，高血压更为常见。有效的病毒抑制ART仍然至关重要。将定期高血压筛查和治疗纳入艾滋病毒护理对于实现最佳健康结果是必要的。
