Abdulkadir Zainab, Kwaku Aminatu Ayaba, Ibrahim Zainab Uba, Olawumi Abdulgafar Lekan, Umar Zainab Abdulazeez, Sheriff Sherifah, Zahradeen Safiya Usman, Tsiga-Ahmed Fatimah Ismail, Musa Baba Maiyaki, Sani Mahmoud Umar, Aliyu Muktar Hassan
Department of Family Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria.
Department of Community Medicine, Bayero University Kano, Kano, Nigeria.
BMC Infect Dis. 2025 Aug 4;25(1):978. doi: 10.1186/s12879-025-11378-4.
Cardiovascular risk assessment is challenging in people living with HIV (PLWH). The aim of this study is to determine the validity of high-sensitivity C-reactive protein (hsCRP) compared to the Data-collection on Adverse effects of Anti-HIV Drugs (DAD) equation for cardiovascular risk prediction in PLWH in Nigeria.
Using a cross-sectional study design, we systematically recruited 180 HIV-positive adults attending a tertiary hospital in Kano, Nigeria. We estimated the 5-year projected CVD risk for each participant using both the DAD equation and hsCRP. The performance of hsCRP as a new tool was then compared to the DAD equation (reference tool) by evaluating sensitivity, specificity and area under the curve (AUC) to discriminate performance.
The mean age (± standard deviation) of the participants was 44.03 ± 10.58 years. The predictive accuracy of hsCRP for high CVD risk showed a specificity of 88.0%, sensitivity of 77.3%, and an AUC of 0.901 (95% confidence interval, CI: 0.824-0.978, p < 0.001) with hsCRP cut-off point for high risk set at > 3.03 mg/L. Comparison between the two models showed a moderate positive correlation (r = 0.58, p < 0.001) and fair agreement (κ = 0.26, p < 0.001). No factors significantly influenced the validity of hsCRP after regression modeling.
hsCRP is an excellent predictor of cardiovascular disease risk in PLWH, independent of traditional risk factors, comorbidities, and sociodemographic characteristics. Our findings suggest that hsCRP could be a feasible option for cardiovascular risk assessment in resource-limited settings, pending further validation in diverse populations.
对感染艾滋病毒的人（PLWH）进行心血管风险评估具有挑战性。本研究的目的是确定与抗逆转录病毒药物不良反应数据收集（DAD）方程相比，高敏C反应蛋白（hsCRP）在尼日利亚PLWH心血管风险预测中的有效性。
采用横断面研究设计，我们系统招募了180名在尼日利亚卡诺一家三级医院就诊的艾滋病毒阳性成年人。我们使用DAD方程和hsCRP对每位参与者估计5年预测心血管疾病风险。然后通过评估敏感性、特异性和曲线下面积（AUC）来比较hsCRP作为一种新工具与DAD方程（参考工具）的性能，以区分性能。
参与者的平均年龄（±标准差）为44.03±10.58岁。hsCRP对高心血管疾病风险的预测准确性显示，特异性为88.0%，敏感性为77.3%，AUC为0.901（95%置信区间，CI：0.824 - 0.978，p < 0.001），高风险的hsCRP截断点设定为> 3.03mg/L。两种模型之间的比较显示出中度正相关（r = 0.58，p < 0.001）和中等一致性（κ = 0.26，p < 0.001）。回归建模后，没有因素显著影响hsCRP的有效性。
hsCRP是PLWH心血管疾病风险的优秀预测指标，独立于传统风险因素、合并症和社会人口学特征。我们的研究结果表明，在资源有限的环境中，hsCRP可能是心血管风险评估的一个可行选择，有待在不同人群中进一步验证。
