Ajayi Oluseye Ayodele, Babatunde Deborah, Ajayi Oluwaseun Kikelomo, Ojo Temitope Olumuyiwa, Okonkwo Prosper
Prevention and Community Service Directorate, APIN Public Health Initiatives, Plot 1551, Zone E, Apo Resettlement, Apo, Abuja, Nigeria.
Health System Strengthening Directorate, APIN Public Health Initiatives, Abuja, Nigeria.
Ther Adv Infect Dis. 2024 Nov 4;11:20499361241293704. doi: 10.1177/20499361241293704. eCollection 2024 Jan-Dec.
The combined effect of the aging human immunodeficiency virus (HIV) population, HIV's natural progression, and HIV drugs have great implications for comorbidity burden and hypertension control among people living with HIV (PLHIV).
This study assessed hypertension burden, treatment outcomes, and treatment outcome predictors among PLHIV in Nigeria.
Cross-sectional design.
A cross-sectional study of 2613 adult PLHIV who initiated antiretroviral therapy (ART) between 2004 and 2020 in two HIV clinics in Northern and Southern Nigeria. Study outcomes were: (1) controlled blood pressure defined as two consecutive blood pressure (BP) measurements of <140/90 mmHg (Joint National Committee guideline (JNC) 7) on the interview day in previously diagnosed hypertensive participants; and (2) HIV viral suppression defined as recent viral load count of <1000 copies/ml in a hypertensive participant. Data were analyzed using Statistical Package of Social Sciences IBM version 23. Univariate and multivariate logistic regression was done to ascertain factors associated with the study outcomes at < 0.05.
The mean age of respondents at the point of the study was 45.3 ± 9.8 years. Most of the participants were female, 1940 (74.2%), on a dolutegravir-based therapy, 2433 (93.2%). About 452 (17.3%) of the participants had clinically diagnosed hypertension. Of those diagnosed hypertensives, 443 (98.0%) were on antihypertensive drugs. About 407 (90.0%) and 229 (51.7%) of the hypertensive PLHIV had HIV viral suppression and controlled hypertension respectively. Factors associated with controlled hypertension were age at ART initiation (adjusted odds ratio (AOR): 0.96, 95% CI: 0.94-0.98), use of thiazide only antihypertensive (AOR: 1.91, 95% CI: 1.73-3.24, Ref: calcium channel blocker only) and thiazide-calcium channel blocker combination (AOR: 2.19, 95% CI: 1.05-4.58). No hypertension comorbidity-related factors were found to be associated with HIV viral suppression.
There is suboptimal hypertension control among hypertensive PLHIV especially those on non-thiazide-based antihypertensive drugs. Close monitoring should be given to hypertension management in PLHIV.
衰老的人类免疫缺陷病毒（HIV）人群、HIV的自然病程以及HIV药物的综合作用对HIV感染者（PLHIV）的合并症负担和高血压控制具有重大影响。
本研究评估了尼日利亚PLHIV中的高血压负担、治疗效果及治疗效果预测因素。
横断面设计。
对2004年至2020年间在尼日利亚北部和南部两家HIV诊所开始接受抗逆转录病毒治疗（ART）的2613名成年PLHIV进行横断面研究。研究结果包括：（1）在访谈日，既往诊断为高血压的参与者连续两次血压（BP）测量值<140/90 mmHg（美国国家联合委员会指南（JNC）7）定义为血压得到控制；（2）高血压参与者近期病毒载量计数<1000拷贝/ml定义为HIV病毒抑制。使用社会科学统计软件包IBM版本23进行数据分析。进行单因素和多因素逻辑回归以确定与研究结果相关的因素，P<0.05。
研究时受访者的平均年龄为45.3±9.8岁。大多数参与者为女性，共1940名（74.2%），接受基于度鲁特韦的治疗，共2433名（93.2%）。约452名（17.3%）参与者临床诊断为高血压。在那些诊断为高血压的患者中，443名（98.0%）正在服用抗高血压药物。分别约有407名（90.0%）和229名（51.7%）高血压PLHIV实现了HIV病毒抑制和血压控制。与血压控制相关的因素包括开始接受ART时的年龄（调整后的优势比（AOR）：0.96，95%置信区间：0.94-0.98）、仅使用噻嗪类抗高血压药物（AOR：1.91，95%置信区间：1.73-3.24，参照：仅使用钙通道阻滞剂）以及噻嗪类-钙通道阻滞剂联合使用（AOR：2.19，95%置信区间：1.05-4.58）。未发现与HIV病毒抑制相关的高血压合并症相关因素。
高血压PLHIV中尤其是那些使用非噻嗪类抗高血压药物的患者，血压控制欠佳。应密切监测PLHIV的高血压管理情况。
