Prevalence and risk factors of peripheral artery disease in black Africans with HIV infection: a cross-sectional hospital-based study

Abstract

Background

The prevalence of peripheral artery disease (PAD) is not well known among HIV-infected patients in Africa. The aim of this study was to determine the prevalence and associated risk factors of PAD among HIV-infected patients at the Douala General Hospital (DGH).

Methods

This was a cross-sectional descriptive and analytic study between November 2015 and April 2016. We recruited patients aged ≥21 years, diagnosed with HIV infection, and who were receiving care at the DGH. We collected sociodemographic data and past medical history of patients. We measured their ankle-brachial index (ABI). We defined PAD as an ABI <0.9. We also measured their fasting blood glucose and lipid profile.

Results

We recruited 144 patients for this study. The mean age was 46±9 years, and 72.2% were females. Of which, 89% were on antiretroviral treatment (ARV). Their mean CD4+ T lymphocytes count was 451±306 cells/mm³. Their mean ABI was 1.12±0.17 and 1.07±0.11, respectively, on the left and right legs (P>0.05). The prevalence of PAD was 6.9% (95% CI: 3.4–12.4), and 60% of patients with PAD were symptomatic. After adjusting for age, sex and ARV, ARV treatment was protective (aOR: 0.18, [95% CI: 0.04–0.82], P=0.034), while WHO stages III or IV was associated with PAD (aOR: 11.1, [95% CI: 2.19–55.92], P=0.004).

Conclusion

The prevalence of PAD was not as high as expected in this group of patients with high cardiovascular risk infected with HIV. Advanced HIV disease was associated with PAD, while ARV was protective.

Keywords:

• HIV
• peripheral artery disease
• prevalence
• risk factors
• Africa

Acknowledgments

We thank the day support staff of the Douala General Hospital for assisting with patient care and comfort. We also thank the participants for taking part in this study.

Author contributions

Conception: FK, YM, BH, and HL. Design: FK, YM, BH, MSD, GI, JPNM, and HL. Data collection: FK, YM, BH, FS, CK, GI, JPNM, MSD, and HL. Data analysis and interpretation: FK, YM, BH, FS, AMJ, MSD and HL. Drafting of manuscript: FK, YM, BH, FS, CK, AMJ, GI, FKL, JKF, and JPNM. Critical review of the final draft: MSD and HL. All authors contributed toward data analysis, drafting and critically revising the paper, gave final approval of the version to be published and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.