Prevalence of Cardiovascular Risk Factors among Persons Living With HIV (PLWHS) On Highly Active Antiretroviral Therapy: A Study in Kumasi South Hospital

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This study estimated prevalence of cardiovascular disease risks and type II diabetes among PLWH on highly active antiretroviral therapy (HAART) at the Kumasi South Hospital. Risk prevalence was measured in three hundred and five (305) PLWHs of which one hundred and sixty four (164) (HAART experienced group) have been on HAART for over six (6) months. Biochemical, haematological and anthropometrical variables were measured in all the 305 participants. Facial and limb lipoatrophy was 11.0% and 23.8% respectively whiles lipohypertrophy of the neck, abdomen, breast and buttocks was 32.2%, 28.7%, 17.1% and 13.4% respectively among the HAART experienced group. Forty one percent (41%) of the HAART experienced participants used Stavudine, Lamivudine and Nevirapine combinations therapy. The prevalence of type II diabetes and IFG among the HAART experienced group were 6.7% and 4.3% respectively. The risk of developing type II diabetes was five (5) times higher in the HAART experienced than the HAART naïve group: X2(P), 7.3(0.0068). 15.2% and 23.8% HAART experienced group developed systolic and diastolic hypertension after six (6) months on therapy respectively. 7.1% of the systolic hypertension and 11.6% of the diastolic hypertension were using d4T/3TC/NVP combination. The risk of developing systolic and diastolic hypertension was five (5) times (p<0.05) among the HAART experienced group. The prevalence of hyperlipidaemia among the HAART experienced group was 3.7% (p<0.0001). High LDLC and low HDLC serum levels were raised among the HAART experienced group (p<0.05) and the risk of developing hyperlipidaemia was four (4) times higher than the HAART naïve group. Truncal obesity based on WHR was prevalent among the HAART experienced population. 49.4% were classified as high risk and the risk of developing truncal obesity was three (3) times higher compared to the HAART naïve group. Type II diabetes showed no significant correlation in terms of BMI, WHR and WC. However IFG which can be an indication for insulin resistance was associated with BMI, WHR and WC. The HAART experienced participants had increased WHR, WC, blood pressure, glucose, and cholesterol levels. The study revealed a high prevalence of multiple risk factors for cardiovascular disease. Factors such as life style changes and nutrition other than body fat redistribution alone may be contributing to the dyslipidaemia and consequently the risk of cardiovascular disease.
A thesis submitted to the Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, in partial fulfillment of the requirements for the degree of Master of Science in Clinical Biochemistry, October-2011