Hirigo Agete Tadewos, Yilma Daniel, Astatkie Ayalew, Debebe Zelalem
School of Medical Laboratory Science, College of Medicine Health Sciences, Hawassa University, Hawassa, Ethiopia.
Center for Food Science and Nutrition, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Ther Adv Infect Dis. 2024 Dec 16;11:20499361241306942. doi: 10.1177/20499361241306942. eCollection 2024 Jan-Dec.
Dolutegravir (DTG), a novel antiretroviral therapy (ART) for HIV, is increasingly adopted across sub-Saharan Africa. However, its impact on blood pressure in Ethiopia remains unclear, highlighting a need for further studies.
This study aimed to investigate the association between DTG-based first-line regimens and other covariates of high blood pressure (HBP) among adults living with HIV receiving care at health facilities in Hawassa City, southern Ethiopia.
A cross-sectional study.
Data were collected between January 2023 and May 2024 among 444 systematically selected adults, complemented with a review of their medical records. HBP was defined according to the seventh report of the Joint National Committee (JNC7) guidelines, with a threshold of systolic or diastolic blood pressure of ⩾120/80 mmHg. Multivariable logistic regression analysis was performed to identify predictors of HBP. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were computed to determine statistically significant associations.
Of the study participants, 58.3% were women and 41.7% were men, resulting in a response rate of 95.5%. The mean (standard deviation (SD]) age of the participants was 38.4(±8.9) years. The prevalence of HBP was 57.9% (95% CI: 52.5-62.4), with 40.5% classified as prehypertension and 17.3% as hypertension. Among participants with hypertension, 84.4% were newly diagnosed. Initiating ART with DTG-based regimens was associated with higher odds of HBP (AOR 5.9; 95% CI: 1.5-22.7) and switching to DTG-based regimens also increased the odds of HBP (AOR 3.8; 95% CI: 1.1-13.9). Other significant covariates associated with HBP included being male (AOR 2.6; 95% CI: 1.4-4.9), age >45 years (AOR 2.0; 95% CI: 1.2-3.4), high waist-to-height ratio (AOR 2.4; 95% CI: 1.1-4.9), inadequate vegetable intake (AOR 1.7; 95% CI: 1.0-2.7), low physical activity (AOR 2.4; 95% CI: 1.1-5.4), and LDL-cholesterol (AOR 1.1; 95% CI: 1.0-1.2).
Proactive blood pressure screening and management are important for individuals on DTG-based regimens. In addition, early identification and intervention of modifiable risk factors through comprehensive strategies and regular screenings are pivotal for improving cardiovascular health among individuals on ART.
多替拉韦（DTG）是一种新型的抗逆转录病毒疗法（ART），用于治疗艾滋病毒，在撒哈拉以南非洲越来越多地被采用。然而，其对埃塞俄比亚血压的影响仍不清楚，这凸显了进一步研究的必要性。
本研究旨在调查在埃塞俄比亚南部哈瓦萨市的医疗机构接受护理的艾滋病毒感染者中，基于DTG的一线治疗方案与高血压（HBP）的其他协变量之间的关联。
一项横断面研究。
在2023年1月至2024年5月期间，收集了444名系统选取的成年人的数据，并对他们的病历进行了回顾。根据美国国家联合委员会（JNC7）指南的第七次报告定义HBP，收缩压或舒张压阈值为⩾120/80 mmHg。进行多变量逻辑回归分析以确定HBP的预测因素。计算调整后的优势比（AOR）及95%置信区间（CI），以确定具有统计学意义的关联。
研究参与者中，58.3%为女性，41.7%为男性，应答率为95.5%。参与者的平均（标准差[SD]）年龄为38.4（±8.9）岁。HBP的患病率为57.9%（95%CI：52.5 - 62.4），其中40.5%被归类为高血压前期，17.3%为高血压。在高血压参与者中，84.4%为新诊断病例。开始使用基于DTG的治疗方案与HBP的较高几率相关（AOR 5.9；95%CI：1.5 - 22.7），改用基于DTG的治疗方案也增加了HBP的几率（AOR 3.8；95%CI：1.1 - 13.9）。与HBP相关的其他显著协变量包括男性（AOR 2.6；95%CI：1.4 - 4.9）、年龄>45岁（AOR 2.0；95%CI：1.2 - 3.4）、高腰高比（AOR 2.4；95%CI：1.1 - 4.9）、蔬菜摄入量不足（AOR 1.7；95%CI：1.0 - 2.7）、低体力活动（AOR 2.4；95%CI：1.1 - 5.4）和低密度脂蛋白胆固醇（AOR 1.1；95%CI：1.0 - 1.2）。
对于接受基于DTG治疗方案的个体，积极的血压筛查和管理很重要。此外，通过综合策略和定期筛查早期识别和干预可改变的风险因素，对于改善接受抗逆转录病毒治疗个体的心血管健康至关重要。
