Acharya Shrikala, Karanjkar Vijaykumar, Goyal Mohit, Deshpande Prashant Vinay, Setia Maninder Singh, Rathod Dhirubhai, Kannan Priya, Krishna Ashish, Pathni Anupam Khungar, Palkar Amol, Harshana Amit
Mumbai Districts AIDS Control Society, Mumbai, Maharashtra, India.
Seth G S Medical College and KEM Hospital, Mumbai, India.
HIV AIDS (Auckl). 2025 Jun 3;17:105-119. doi: 10.2147/HIV.S499508. eCollection 2025.
Globally, non-communicable diseases (NCDs), including hypertension, are the leading cause of mortality. People Living with HIV (PLHIV) on antiretroviral therapy (ART) have a higher prevalence of hypertension, risk of cardiovascular events, and all-cause mortality than HIV-uninfected individuals. We describe the implementation of an integrated hypertension screening initiative in a routine program setting and assessed the prevalence of hypertension and its associated factors among PLHIV accessing services at ART centers in Mumbai, India.
From November 2021 to October 2022, we implemented hypertension screening across 21 ART centers in Mumbai, India. An expert committee developed a clinical protocol for hypertension management among PLHIVs aged ≥18 years, and ART center staff were trained on hypertension screening and management. We measured the prevalence of hypertension and determined the relationship between hypertension and various factors using univariable and multivariable modified poisson regression.
We screened 92% (36,098/39,402) of eligible adult PLHIV for hypertension; 23.8% (8,604/36,098) had hypertension (56.7% were newly identified, and 43.3% known cases), factors such as age ≥60 years, male gender, being overweight or obese were significantly associated with hypertension (p<0.05). The HIV-related factors such as CD4 cell count of 200 cells/mm or higher, suppressed viral load (<1000 copies/mL), and longer duration of ART were also significantly associated with hypertension.
About one in every four PLHIV enrolled in the Mumbai ART program was hypertensive, reflecting hypertension prevalence in the general population. The findings highlight the increasing concern of NCDs among PLHIV, driven by longer life expectancies due to effective ART. This underscores the need for healthcare systems to evolve and adopt comprehensive and integrated care models that address HIV and non-communicable diseases. Integration of hypertension screening into routine HIV care can accelerate the early identification and management of hypertension.
在全球范围内，包括高血压在内的非传染性疾病是主要的死亡原因。接受抗逆转录病毒治疗（ART）的艾滋病病毒感染者（PLHIV）比未感染艾滋病病毒的个体患高血压的几率更高，发生心血管事件的风险更高，全因死亡率也更高。我们描述了在常规项目环境中实施的一项综合高血压筛查倡议，并评估了在印度孟买接受抗逆转录病毒治疗中心服务的艾滋病病毒感染者中高血压的患病率及其相关因素。
2021年11月至2022年10月，我们在印度孟买的21个抗逆转录病毒治疗中心开展了高血压筛查。一个专家委员会制定了针对年龄≥18岁的艾滋病病毒感染者高血压管理的临床方案，并对抗逆转录病毒治疗中心的工作人员进行了高血压筛查和管理方面的培训。我们测量了高血压的患病率，并使用单变量和多变量修正泊松回归确定了高血压与各种因素之间的关系。
我们对92%（36,098/39,402）符合条件的成年艾滋病病毒感染者进行了高血压筛查；23.8%（8,604/36,098）患有高血压（56.7%为新确诊病例，43.3%为已知病例），年龄≥60岁、男性、超重或肥胖等因素与高血压显著相关（p<0.05）。与艾滋病病毒相关的因素，如CD4细胞计数为200个细胞/mm³或更高、病毒载量被抑制（<1000拷贝/mL）以及抗逆转录病毒治疗时间更长，也与高血压显著相关。
在孟买抗逆转录病毒治疗项目中登记的艾滋病病毒感染者中，约四分之一患有高血压，这反映了普通人群中的高血压患病率。研究结果凸显了由于有效的抗逆转录病毒治疗使预期寿命延长，艾滋病病毒感染者中非传染性疾病问题日益受到关注。这强调了医疗保健系统需要发展并采用全面综合的护理模式，以应对艾滋病病毒和非传染性疾病。将高血压筛查纳入常规艾滋病病毒护理可以加速高血压的早期识别和管理。
