Risk factors and assessment for cardiovascular disease among HIV-positive patients attending a Nigerian tertiary hospital

Abstract

INTRODUCTION: cardiovascular risk factors are prevalent in HIV-positive patients which places them at increased risk for cardiovascular disease (CVD). We aimed to determine the risk factors and risk assessment for CVD in HIV-positive patients with and without antiretroviral therapy. METHODS: this was a cross-sectional study of HIV-positive patients attending the Lagos University Teaching Hospital, Nigeria. Anthropometric and blood pressure measurements were performed; fasting lipid profile, plasma glucose, homocysteine and hsCRP were determined,as well as prevalences and risk assessments. Statistical tests were used to compare the groups and p-value 0.05 was considered to be significant. RESULTS: 283 subjects were recruited for this study (100 HIV-positive treatment-naive, 100 HIV-positive treated and 83 HIV negative controls). Compared to the controls, mean (sd) values were significantly higher among HIV-treated subjects: waist circumference=88.7 (10.4), p=0.035; systolic bp= 124.9 (20.7), p=0.014; glucose= 5.54 (1.7), p=0.015; triglyceride= 2.0 (1.2), p=0.001; homocysteine= 10.9 (8.9-16.2), p=0.0003; while hsCRP= 2.9 (1.4-11.6), p=0.002 and HDL-C=0.9 (0.4), p==0.0001 were higher among the HIV-naïve subjects. Likewise, higher prevalences of the risk factors were noted among the HIV-treated subjects except low HDL-C (p=0.001) and hsCRP (p=0.03) which were higher in the HIV-naïve group. Risk assessment using ratios showed high risk for CVD especially in the HIV-naïve group. The median range for Framingham risk assessment was 1.0 - 7.5%. CONCLUSION: risk factors and risk assessment for CVDare increased in HIV-positive patients with and without antiretroviral therapy.Routine evaluation and risk assessment for CVD irrespective of therapy status is necessary to prevent future cardiovascular events.

Keywords

• atherosclerosis
• cardiovascular disease
• hiv
• risk assessment