Cardiometabolic syndrome among HIV patients on protease inhibitors based anti-retroviral treatment at Zewuditu Memorial Hospital
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Date
2019-10
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Addis Ababa University
Abstract
The human immunodeficiency virus is a human T-cell lymphotropic retrovirus of the lentivirus subgroup
that induces immune-suppression and causes the acquired immunodeficiency syndrome (AIDS). Antiretroviral
therapy (ART) has definitely decreased mortality and increased the quality of life of affected
individuals but using highly active anti-retroviral therapy (HAART) containing especially protease
inhibitors (PIs) in HIV infection management has led to increased prevalence of cardiometabolic
syndrome (CMS). Although several studies on CMS in HIV-positive patients on HAART, and the risk of
cardiovascular disease (CVD) has been conducted in many countries, there are few researches especially
on PIs conducted in Ethiopia. Therefore, the aim of this study was to narrow this gap and determine the
magnitude of CMS components including hypertension, dyslipidemia and diabetes to identify the risk of
CVD among HIV-positive patients on HAART. Hospital based prospective cohort study was conducted
at Zewditu Memorial Hospital between March 2018 to December 2018. The source population included
all HIV patients who were on chronic HAART follow up. All HIV patients that met the inclusion criteria
were recruited over a four-month period. Socio-demographic, medical history, behavioral and dietary
exposures were obtained from patient self-report data using a structured questionnaire. The data were
entered and processed using SPSS version 23 statistical software. Ethical clearance was obtained from
Institutional Review Board of the College of Health Sciences, Addis Ababa University and Addis Ababa
Health Bureau. One hundred forty patients, 52 males (37.1%) and 88 females (62.9%) were included in
the study. Using Adult Treatment Pannel III criteria 59 patients (42.1%) were diagnosed for the presence
of CMS. The prevalence of hypertension, hypertriglyceridemia, impaired fasting glucose (IFG) and
abnormal waist circumference were 50.0%, 65.7%, 67.1% and 47.1%, respectively. In multivariate
analysis, having abnormal BMI, i.e., over weight (AOR: 4.87, CI: 1.49-15.69) and total cholesterol ≥ 200
mg/dl (AOR: 3.67, CI: 1.17-11.49) were independently associated with CMS. High prevalence of CMS
(42.1%) among HIV infected patients receiving PIs was observed. Prevalence in CMS components was
also higher, IFG being the most prevalent one.
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Keywords
Dyslipidemia; Impaired Fasting Glucose; Hypertension; Obesity; Protease Inhibitors based Anti-retroviral Therapy