Prevalence and associated risk factors of peripheral artery disease in virologically suppressed HIV-infected individuals on antiretroviral therapy in Kwara state, Nigeria: a cross sectional study

Chidozie Elochukwu Agu, Ikenna Kingsley Uchendu, Augusta Chinyere Nsonwu, Chukwugozie Nwachukwu Okwuosa, Peter Uwadiegwu Achukwu, Chidozie Elochukwu Agu, Ikenna Kingsley Uchendu, Augusta Chinyere Nsonwu, Chukwugozie Nwachukwu Okwuosa, Peter Uwadiegwu Achukwu

Abstract

Background: The association between HIV and cardiovascular disease (CVD) has been reported in several studies. However, there is paucity of information on the prevalence of subclinical disease as well as its associated risk factors in sub-Saharan African population. The aim of this study was to determine the prevalence and associated risk factors of peripheral artery disease (PAD) among virologically suppressed HIV-infected participants in Kwara State, Nigeria.

Methods: This study was conducted between July 2018 and December 2018. A total of 150 HIV-infected participants aged between 20 and 55 years and 50 HIV non-infected age-matched controls were randomly recruited in the study. Sociodemographic, anthropometric and clinical data were collected using a well-structured questionnaire. Ankle brachial index (ABI) was measured, PAD was defined as ABI of < 0.9. Cryopreserved serum was used to evaluate lipid profile parameters. Student's t-test and Chi-square were used to compare continuous and categorical variables. Associations of CVD risk factors and clinical data, and lipid profile with low ABI were assessed using logistic regression analysis.

Results: The study participants had a mean age of 43.73 ± 8.74, majority were females (72.7%) with a mean duration on ART of 7.73 ± 3.52 years. Hypertension was present in 15.9%, diabetes 4%, family history of CVD 8.6% and metabolic syndrome 17.3% in the study group. The study participants recorded significantly lower mean values for ABI, HDL-C and significantly higher mean values of TG (P < 0.05) compared to the control group. The prevalence of low ABI (14.6%) was higher in the study group compared to the control group (2%). A significantly negative correlation between ABI and duration on ART (r = - 0.163, P = 0.041) and a positive correlation between viral load and TG were observed in the study group. TC (OR 1.784, P = 0.011), LDL-C (OR 1.824, P = 0.010) and CD4 cell count < 200 cells/mm3 (OR 2.635, P = 0.364) were associated with low ABI in the participants.

Conclusion: Viral suppression with combined antiretroviral therapy and long term treatment is associated with dyslipidaemia, with increased risk of PAD. Prevalence of PAD in virologically-suppressed individuals does not differ from the controls in the population studied.

Keywords: Antiretroviral therapy; Cardiovascular disease; Dyslipidemia; HIV; Metabolic syndrome.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Correlation plot of triglyceride against viral load in HIV-infected study group. The preliminary analysis of the data showed that a significantly positive correlation was observed between triglyceride and viral RNA count
Fig. 2
Fig. 2
Correlation plot of Duration on ART against ankle brachial index (ABI) in HIV-infected study group. The preliminary analysis of the data showed that a significantly negative correlation was observed between duration of ART (years) and ankle brachial index in the study group

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