Duration of antiretroviral therapy among people living with HIV and incidence of hypertension in Ghana

Singh, Arti; Tagge, Raelle; Mensah, Gideon; Ovbiagele, Bruce

doi:10.1111/jch.14088

Cited by 11 publications

(19 citation statements)

References 34 publications

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“…Furthermore, cumulative drug toxicities and non-AIDS-related morbidities in those living with HIV and treated since birth are largely unknown. In older people living with HIV, an increased risk of developing ART-related morbidities such as diabetes, hypertension, and cardiovascular disease, among others, has been observed [10][11][12][13][14]. These ART-related morbidities may occur in individuals born with HIV as they progress in age, along with other unknown complications related to life-long infection and treatment.…”

Section: Introductionmentioning

confidence: 99%

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HIV-1 Persistence in Children during Suppressive ART

Katusiime

Zyl

Cotton

et al. 2021

Viruses

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There is a growing number of perinatally HIV-1-infected children worldwide who must maintain life-long ART. In early life, HIV-1 infection is established in an immunologically inexperienced environment in which maternal ART and immune dynamics during pregnancy play a role in reservoir establishment. Children that initiated early antiretroviral therapy (ART) and maintained long-term suppression of viremia have smaller and less diverse HIV reservoirs than adults, although their proviral landscape during ART is reported to be similar to that of adults. The ability of these early infected cells to persist long-term through clonal expansion poses a major barrier to finding a cure. Furthermore, the effects of life-long HIV persistence and ART are yet to be understood, but growing evidence suggests that these individuals are at an increased risk for developing non-AIDS-related comorbidities, which underscores the need for an HIV cure.

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Section: Introductionmentioning

confidence: 99%

“…Viruses 2021, 13, 1134 2 of 15 The high cost of treating over 1.8 million individuals (and counting) is not economically sustainable, particularly in the developing world where most of the disease burden exists. For these reasons, a cure is warranted.…”

Section: Introductionmentioning

confidence: 99%

HIV-1 Persistence in Children during Suppressive ART

Katusiime

Zyl

Cotton

et al. 2021

Viruses

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“…Hypertension is the leading risk factor for CVD and cerebrovascular mortality 19 and has been reported to be common among PLWH. 20,21 Several prevalence figures of hypertension in PLWH have been reported globally, ranging from 19.9% in Brazil 22 to 31.5% in Southern America Cohort. 23 Results of other studies in SSA among PLWH (ART-exposed and ART-naive combined) indicate the prevalence of hypertension ranging from a low of 14.0% in Botswana to a high of 32.0% in Kenya.…”

Section: Discussionmentioning

confidence: 99%

Hypertension and associated factors among patients attending HIV clinic at Korle-Bu Teaching Hospital

Nartey

Tetteh

Anto

et al. 2023

gmj

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Objectives: This study determined the prevalence of hypertension and its associated factors among patients attending the HIV clinic at the Korle-Bu Teaching Hospital (KBTH).Design: A hospital-based cross-sectional study was conducted at KBTH. The prevalence of hypertension was estimated among study participants, and socio-demographic, lifestyle, anthropometric, metabolic and HIV/ART-related factors associated with hypertension were determined by logistic regression modelling.Setting: Study participants were recruited from the HIV clinic at the KBTH.Participants: A total of 311 Persons Living with HIV were recruited as study participantsInterventions: Simple random sampling technique was used to recruit study participants. A questionnaire adapted from the WHO STEPwise approach to chronic disease risk-factor surveillance was used to collect study participants' data.Results: The prevalence of hypertension was 36.7%, and the factors associated with hypertension were increasing age, positive family history of hypertension, minimal exercising, current BMI ≥25.0 kg/m2, total cholesterol level ≥5.17 mmol/L, exposure to anti-retroviral therapy (ART) and increasing duration of ART exposure.Conclusions: This study shows a high prevalence of hypertension among patients attending the HIV clinic at KBTH, associated with exposure to ART and increasing duration of this exposure. Blood pressure monitoring should move from routine to a more purposeful screening of patients for hypertension. Patients with the identified risk factors should be encouraged to have regular blood pressure measurements at home and not only when they visit the HIV clinic.

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“…The need for a greater focus towards prevention and early detection of CKD in low-and middle-income countries has been emphasized in global health literature 47,48 , in part because treatment for ESRD is highly specialized 49 and costly for healthcare systems already challenged with scarcer resources than HICs. This is particularly important since other comorbidities contributing to CKD are increasingly seen in this population 50,51 .…”

Section: Discussionmentioning

confidence: 99%

Predictors of long-term progression to chronic kidney disease in HIV infection in Ghana from 2003-2018

Chadwick

Barker

Smith

et al. 2022

Preprint

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AimHIV is associated with an increased risk of progression to chronic kidney disease (CKD), and this risk is higher in people of West African descent than many other ethnicities. Our study aimed to assess the rates of progression to CKD and predictors of rapid progression in patients receiving antiretroviral therapy (ART) in central Ghana between 2003 and 2018.MethodsThis single-centre retrospective study enrolled people with HIV (PWH) initiating ART in Ghana between 2003-2018. Demographics, hepatitis B (HBsAg) status, ART regimens and eGFR measurements were recorded, and multi-level model linear regression was performed to determine predictors of greater levels of eGFR decline.Results659 participants were included in the study with a median follow-up time of 6 years (IQR 3.6-8.9). 149 participants (22.6%) also had confirmed HBV co-infection. Tenofovir was associated with the highest mean rate of eGFR decline of all Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs), representing a statistically significant annual decline -1.08 mL/min/1.73m2/year (CI: -0.24, -1.92) faster than those taking zidovudine. Regarding other ARTs, both nevirapine (-0.78mL /min/173m2/year; CI: -0.17, -1.39) and protease inhibitors (-1.55mL/mil/173m2/year; CI: - 0.41, -2.68) were associated with slower eGFR declines compared with efavirenz. Negative HbsAg status was associated with greater eGFR decline compared with positive HBsAg status (-1.25mL/mil/173m2; CI 0.29. 2.20).ConclusionIncreased rates of eGFR decline amongst PWH in Ghana were associated with tenofovir, nevirapine, and protease inhibitor use as well as negative HBsAg status. Further higher-quality research is needed to explore long-term predictors of eGFR decline in African populations.

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Duration of antiretroviral therapy among people living with HIV and incidence of hypertension in Ghana

Cited by 11 publications

References 34 publications

HIV-1 Persistence in Children during Suppressive ART

HIV-1 Persistence in Children during Suppressive ART

Hypertension and associated factors among patients attending HIV clinic at Korle-Bu Teaching Hospital

Predictors of long-term progression to chronic kidney disease in HIV infection in Ghana from 2003-2018

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