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Title: | Burden of subclinical carotid atherosclerosis and vascular risk factors among people living with HIV in Ghana |
Authors: | Sarfo, Fred Stephen Nichols, Michelle Agyei, Benedict Singh, Arti Ennin, Eugenia Nyantakyi, Adu Darko Osei Asibey, Shadrack Tagge, Raelle Gebregziabher, Mulugeta |
Keywords: | HIV Cardiovascular risk Stroke Dyslipidemia Carotid atherosclerosis |
Issue Date: | Dec-2018 |
Publisher: | Journal of the Neurological Sciences |
Citation: | Journal of the Neurological Sciences, 397 (2019) 103–111 |
Abstract: | Background: The burden of cardiovascular disease (CVD) among people living with HIV (PLWH) in sub-Saharan
Africa is projected to rise due to a rapid epidemiological transition and improved treatment of HIV infection on
the sub-continent.
Objective: The Evaluation of Vascular Event Risk while on Long-term Anti-retroviral Suppressive Therapy
(EVERLAST) Study sought to assess the extent of subclinical atherosclerosis and characterize the nature of CVD
risk factors among HIV patients on Antiretroviral therapy (ART) in Ghana.
Methods: We conducted a cross-sectional study involving HIV patients on antiretroviral therapy (n=250) in
comparison with HIV positive ART naïve (n=201), and HIV uninfected controls (n=250). We assessed prevalence
of hypertension, dyslipidemia, diabetes mellitus, central obesity, and carotid atherosclerosis using Bmode
carotid Doppler ultrasonography. We assessed factors associated with subclinical atherosclerosis defined
by a carotid intimal media thickness (CIMT) cut-off of ≥0.78mm among PLWH using a logistic regression
model.
Results: Mean age of PLWH on combination ART (cART) was 45.7 ± 8.6 years, 42.9 ± 8.8 years among PLWH
not on cART, and 44.9 ± 9.5 years among HIV negative controls of which 81.2%, 81.6% and 81.1% respectively
were females. Prevalence of subclinical atherosclerosis at the common carotid artery in the three groups was
67.6%, 66.7% and 62.4%, p=0.43. Among PLWH, raised serum total cholesterol (OR 1.16, 95% CI: 1.00–1.35)
and triglycerides (OR 1.32, 95% CI: 1.01–1.73) were significantly associated with subclinical atherosclerosis.
Prevalence of vascular risk factors among PLWH on cART, PLWH cART naïve, and HIV negative controls respectively
were as follows: dyslipidemia- 79.5%, 83.1%, and 73.5%, p=0.04; hypertension- 40.2%, 23.4%, and
44.9%, p < 0.0001; central obesity-61.8%, 66.7%, and 78.2%, p < 0.0001; diabetes mellitus-6.8%, 5.5% and
4.9%, p=0.53.
Conclusion: Overall while there is a high baseline prevalence of CVD risk factors in the Ghanaian population,
serum lipid derangements appear to be more prevalent among HIV infected patients, and are linked to subclinical
atherosclerosis. Future studies need to confirm these findings, explore the underlying pathophysiology,
and optimize treatment strategies to avert untoward CVD outcomes. |
Description: | This article is published by Journal of the Neurological Sciences and is also available at https://doi.org/10.1016/j.jns.2018.12.026 |
URI: | 10.1016/j.jns.2018.12.026 http://hdl.handle.net/123456789/15648 |
Appears in Collections: | College of Health Sciences
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