Prevalence of Clinical Cardiovascular Disease Risk Factors Among HIV Infected Patients on Anti-Retroviral Treatment in a Tertiary Hospital in Ethiopia

Figures & data

Table 1 Sociodemographic and Clinical Characteristics of Patients, SPHMMC, Addis Ababa, 2020

	Total	Male N (%)	Female N (%)
Age group
≤39 years	98 (30.6%)	13 (12.9%)	85 (38.8%)
40–59 years	191 (59.7%)	74 (73.3%)	117 (53.4%)
≥60	31 (9.7%)	14 (13.9%)	17 (7.8%)
Missing	13 (3.9%)
Marital status
Never married	25 (8%)	13 (13.4%)	12 (5.6%)
Married	140 (44.7%)	64 (66%)	76 (35.2%)
Separated/divorced	67 (21.4%)	11 (11.4%)	56 (25.9%)
Widowed	81 (25.9%)	9 (9.3%)	72 (33.3%)
Missing	20 (6%)
Education
No education	54 (16.4%)	10 (9.8%)	44 (19.3%)
Primary school	138 (41.8%)	41 (40.2%)	97 (42.5%)
Secondary school	98 (29.7%)	32 (31.3%)	66 (29%)
College or higher	40 (12.1%)	19 (18.7%)	21 (9.2%)
Missing	3 (0.9%)
CD4 count (cells/mm^3)
< 200	18 (6.5%)	7 (8.3%)	11 (5.7%)
200–349	43 (15.5%)	9 (10.7%)	34 (17.6%)
350–499	61 (22%)	21 (25%)	40 (20.7%)
≥ 500	155 (56%)	47 (56%)	108 (56%)
Missing	56 (16.8%)
Viral load (copies/mL)
< 50	202 (80.8%)	64 (84.2%)	138 (79.3%)
≥ 50	48 (19.2%)	12 (15.8%)	36 (20.7%)
Missing	83 (24.9%)
Current regimen
TDF/3TC/EFV OR NVP	228 (69.3%)	68 (67.3%)	160 (70.2%)
AZT/3TC/EFV OR NVP	69 (21%)	22 (21.8%)	47 (20.7%)
TDF OR AZT/3TC/LPV/R	6 (1.8%)	4 (4%)	2 (0.9%)
Other	26 (7.9%)	7 (6.9%)	19 (8.3%)
Missing	4 (1.2%)
Mean years since diagnosis	10.58 ± 3.9	11.18 ± 3.8	10.3 ± 3.8
Mean years on ART	10.07 ± 3.9	10.86 ± 3.8	9.69 ± 3.86

Abbreviations: 3TC, Lamivudine; ART, Anti-Retroviral Treatment; AZT, Zidovudine; EFV, Efavirenz; LPV, Lopinavir/ritonavir; NVP, Nevirapine; TDF, Tenofovir Disoproxil Fumarate.

Table 2 Anthropometric and Biochemical Characteristics of Patients, SPHMMC, Addis Ababa, 2020

	Total Mean ± SD	Male, Mean ± SD	Female, Mean ± SD
Weight (Kg)	62.9 ± 13.2	67.1 ± 14.1	61 ± 12.5
Height (cm)	161 ± 8.8	169 ± 8.4	157.4 ± 6.3
BMI (Kg/m^2)	24.3 ± 4.5	23.7 ± 4.3	24.6 ± 4.5
Waist circumference (cm)	91.7 ± 11.7	89.1 ± 10	93 ± 12.4
Hip circumference (cm)	98.2 ± 12.1	97.7 ± 10.5	98.4 ± 12.8
Waist to hip ratio	0.94 ± 0.1	0.94 ± 0.1	0.94 ± 0.1
Mean SBP (mmHg)	121.9 ± 19.1	126.3 ± 19.7	120.1 ± 18.6
Mean DBP (mmHg)	79.6 ± 11.1	81.7 ± 11	78.7 ± 11
Fasting blood glucose (mg/dl)	102.7 ± 57.1	104.9 ± 36	101.9 ± 64.4
Total cholesterol (mg/dl)	206.8 ± 45.8	204.2 ± 47.3	208 ± 45.2
Triglyceride (mg/dl)	152.3 ± 76.8	179.3 ± 97.7	141.1 ± 63.5
HDL-C (mg/dl)	58.4 ± 17.3	54.6 ± 18.5	60.3 ± 16.6
LDL-C (mg/dl)	127.9 ± 37.6	123.8 ± 39	129.6 ± 37

Abbreviations: DBP, Diastolic blood pressure; HDL-C, High density lipoprotein-cholesterol; LDL-C, Low density lipoprotein-cholesterol; SBP, Systolic blood pressure.

Table 3 Cardiovascular Risk Factors of Patients, SPHMMC, Addis Ababa, 2020

	Total	Male N (%)	Female N (%)
Blood pressure (mmHg)
SBP <130 and/or DBP <85	210 (64.4%)	51 (51.5%)	159 (70%)
SBP 130–139 and/or DBP 85–89	38 (11.7%)	14 (14.1%)	24 (10.6%)
SBP 140–159 and/or DBP 90–99	55 (16.9%)	24 (24.2%)	31 (13.7%)
SBP ≥160 and/or DBP ≥100	23 (7.1%)	10 (10.1%)	13 (5.7%)
Missing	7 (2.1%)
Current tobacco use
Yes	6 (1.8%)	4 (3.9%)	2 (0.9%)
No	328 (98.2%)	99 (96.1%)	228 (99.1%)
Current Alcohol use
Yes	7 (2.1%)	3 (2.9%)	4 (1.7%)
No	326 (97.9%)	100 (97.1)	226 (98.3%)
BMI (Kg/m^2)
Underweight	28 (8.7%)	10 (10.1%)	18 (8.1%)
Normal	156 (48.4%)	57 (57.6%)	99 (44.4%)
Overweight	102 (31.7%)	22 (22.2%)	80 (35.9%)
Obese	36 (11.1%)	10 (10.1%)	26 (11.6%)
Missing	11 (3.3%)
Waist circumference >94/80 in males/females (cm)
Yes	68 (63.6%)	10 (27.8%)	58 (81.7%)
No	39 (36.4%)	26 (72.2%)	13 (18.3%)
Missing	226 (67.9%)
Waist to hip ratio >0.9/0.85 in males/females
Yes	85 (80.2%)	27 (77.1%)	58 (81.7%)
No	21 (19.8%)	8 (22.9%)	13 (18.3%)
Missing	227 (68.2%)
Fasting blood glucose (mg/dl)
Less than 100	199 (63.2%)	57 (60%)	142 (64.5%)
100–125	87 (27.6%)	27 (28.4%)	60 (27.3%)
≥126	29 (9.2%)	11 (11.6%)	18 (8.2%)
Missing	18 (5.4%)
Total cholesterol >200 (mg/dl)
Yes	166 (52.4%)	51 (51.5%)	115 (52.8%)
No	151 (47.6%)	48 (48.5%)	103 (47.2%)
Missing	16 (4.8%)
Triglyceride >150 (mg/dl)
Yes	120 (37.3%)	50 (50.5%)	70 (31.4%)
No	202 (62.7%)	49 (49.5%)	153 (68.6%)
Missing	11 (3.3%)
HDL-cholesterol <40 (mg/dl)
Yes	34 (10.7%)	17 (17.2%)	17 (7.7%)
No	285 (89.3%)	82 (82.8%)	203 (92.3%)
Missing	14 (4.2%)
LDL-cholesterol >130 (mg/dl)
Yes	140 (44.4%)	35 (35.7%)	105 (48.4%)
No	175 (55.6%)	63 (64.3%)	112 (51.6%)
Missing	18 (5.4%)
Metabolic syndrome
Yes	63 (22.9%)	20 (25.6%)	43 (21.8%)
No	212 (77.1%)	58 (74.4%)	114 (78.2%)
Missing	58 (17.4)
Framingham risk score
<10%	281 (95.9%)	82 (87.2%)	199 (100%)
10–20%	11 (3.8%)	11 (11.7%)	-
>20%	1 (0.3%)	1 (1.1%)	-
Missing	40 (12%)

Abbreviations: BMI, Body mass index; DBP, Diastolic blood pressure; HDL-C, High density lipoprotein-cholesterol; LDL-C, Low density lipoprotein-cholesterol; SBP, Systolic blood pressure; WHO, World health organization.

Table 4 Multivariate Logistic Regression Analysis of Factors Associated with CVD Risk Factors, SPHMMC, Addis Ababa, 2020

	Crude OR	95% CI	P-value	Adjusted OR	95% CI	P-value
Hypertension
Age group			0.006			0.049*
<40	1 (R)			1 (R)
40–59	3.63	1.62–8.13	0.002	2.52	1.11–5.68	0.027*
≥60	3.64	1.17–11.28	0.025	3.59	1.08–11.95	0.037*
Male gender	0.41	0.23–0.73	0.003	2.767	1.37–5.59	0.005*
BMI			0.091			0.022*
Underweight	1 (R)			1 (R)
Normal	3.12	0.69–14	0.138	4.06	0.84–19.72	0.082
Overweight	3.53	0.77–16.24	0.105	5.26	1.02–27.05	0.047*
Obese	6.95	1.15–31.23	0.019	13.79	2.29–83.17	0.004*
Previous ART regimen	4.13	1.71–9.93	0.005	1.14	0.23–5.76	0.538
Current ART regimen	2.46	1.11–5.44	0.144	1.21	0.33–4.4	0.436
Elevated blood glucose
Age			0.015			0.056
<40	1 (R)			1 (R)
40–59 years	2.08	1.2–3.6	0.009	2.34	1.16–4.7	0.017
≥60	2.79	1.15–6.75	0.023	2.13	0.71–6.4	0.179
Elevated LDL cholesterol	1.79	1.08–2.98	0.024	0.85	0.4–1.83	0.683
Elevated total cholesterol	2.07	1.24–3.46	0.006	2.15	0.97–4.77	0.061
Current ART regimen	0.25	0.11–0.6	0.001	0.32	0.11–0.96	0.092
Previous ART regimen	0.49	0.2–1.21	0.194	0.37	0.6–2.24	0.68
CD4 count	0.32	0.08–1.25	0.09			0.148
<200	1 (R)			1 (R)
200–349	0.44	0.13–1.47	0.183	0.28	0.07–1.2	0.087
350–499	1.41	0.48–4.17	0.53	0.86	0.23–3.2	0.819
≥ 500	1.06	0.39–2.89	0.91	0.68	0.19–2.4	0.550
Dyslipidemia
Age group			<0.001			<0.001*
<40	1 (R)			1 (R)
40–59 years	3.08	1.76–5.38	<0.001	3.61	1.95–6.72	<0.001*
≥60	2.4	0.91–6.33	0.077	2.45	0.86–7.01	0.094
Hypertension	1.54	0.8–2.95	0.193	1.06	0.5–2.28	0.873
BMI			0.031			0.044*
Underweight	1 (R)			1 (R)
Normal	1.29	0.54–3.06	0.565	1.53	0.6–3.9	0.375
Overweight	3.06	1.19–7.86	0.02	3.67	1.3–10.1	0.014*
Obese	1.75	0.57–5.32	0.327	2	0.58–6.86	0.277
Elevated blood glucose	1.2	0.66–2.17	0.036	1.13	0.59–2.17	0.097
Obesity
Age			0.761			0.941
<40	1 (R)			1 (R)
40–59 years	1.34	0.62–2.94	0.998	1.18	0.47–2.98	0.727
Hypertension	2.32	1.03–5.18	0.041	2.1	0.85–5.23	0.11
Previous ART regimen (TDF + 3TC + NVP)	9.05	3.01–27.23	<0.01	7.88	2.55–24.32	<0.001*
Metabolic syndrome
Age			0.039			0.051
<40	1 (R)			1 (R)
40–59 years	2.43	1.2–4.91	0.013	2.04	0.87–4.78	0.101
≥60	2.61	0.89–7.61	0.079	5	1.31–19.03	0.018
CD4 count			0.199			0.187
<200	1 (R)			1 (R)
200–349	0.2	0.04–0.99	0.049	0.15	0.03–0.85	0.032
350–499	0.76	0.21–2.72	0.672	0.53	0.13–2.12	0.372
≥ 500	0.64	0.2–2.04	0.455	0.53	0.15–1.83	0.315
BMI			0.05			0.029*
Underweight	1 (R)			1 (R)
Normal	4.55	0.58–35.7	0.15	4.02	0.49–32.68	0.194
Overweight	8.24	1.04–65.37	0.046	9.35	1.13–77.54	0.038*
Obese	11.2	1.26–99.26	0.03	12.17	1.28–115.5	0.03*

Note: *P-value <0.05.

Abbreviations: 3TC, Lamivudine; BMI, Body mass index; CD4, Cluster of differentiation 4; NVP, Nevirapine; OR, odds ratio; R, Reference; TDF, Tenofovir Disoproxil Fumarate.