Hypertension and associated factors in HIV-infected patients receiving antiretroviral treatment in Burundi: a cross-sectional study

Abstract

Currently, the life expectancy of people living with the human immunodeficiency virus (HIV) and the general population are similar. Hypertension is a major public health issue in Africa and is largely underdiagnosed. Most HIV-infected individuals, especially those on Anti-Retroviral Therapy (ART) have hypertension. Our project aims to determine the prevalence of hypertension and associated factors amongst HIV-infected adults treated by ART in Burundi. A cross-sectional study was conducted among HIV-infected subjects over the age of 20, managed in five healthcare centers for people living with HIV (PLWH). The World Health Organization STEPWISE survey and anthropometric measurements were employed. Blood pressure was measured according to the ESC 2018 recommendations. 1 250 HIV-infected patients aged between 35.4 and 50.2 years were included (18.4% men). The prevalence of hypertension was 17.4% (95% CI 13.2–22.1). Approximately 47.25% of HIV patients with hypertension were previously undiagnosed. Other factors were associated with HTN, such as being overweight (OR 2.88; 95% CI 1.46–5.62), obesity (OR 2.65; 95% CI 1.27–5.55), longer duration of HIV infection: ≥ 10 years (OR 1.04; 95% CI 1.14–3.20), diabetes (OR 2.1; 95% CI 1.37–3.32) and age (OR 1.13; 95% CI 1.09–1.14). Despite their young age, almost 20% of HIV-ART treated patients had hypertension, 50% of these were undiagnosed. Blood pressure monitoring is crucial in these patients, especially those identified as high-risk, with prompt life and disability-saving interventions.

Hypertension Among Persons Living With HIV/Aids and Its Association With Hiv-Related Health Factors

“…From our study, we observed a prevalence of hypertension among People Living with HIV (PLHIV) at 17.4%. This prevalence aligns closely with ndings from studies conducted in Burundi and Zambia [13,14]. Slightly lower prevalence rates were reported from studies conducted in Ethiopia (14%) and Tanzania (8%) [26,27].…”

“…Of note is the nding that factors such as the duration of HIV diagnosis, HIV type, viral load, duration on treatment, antiretroviral adherence rate, and antiretroviral regimen were not signi cantly associated with hypertension in our study. Similar ndings have been reported in several studies investigating the association between hypertension and these HIV-related health factors [13,42]. In contrast, some studies have reported associations between hypertension and antiretroviral medication regimens based on Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) and Protease Inhibitors (PIs) [14,43].…”

“…A study conducted in Kenya estimated the prevalence of hypertension among PLHIV on antiretroviral therapy to range from 6-50% [12]. Similarly, investigations in Burundi and Zambia reported prevalence rates of 17.4% and 18.4%, respectively [13,14].…”

“…Epidemiological factors contributing to the increased prevalence of hypertension among PLHIV are manifold. The improved survival of PLHIV receiving antiretroviral therapy is associated with a heightened risk of developing traditional hypertension risk factors, such as advancing age, lifestyle-related risk factors, and comorbid medical conditions [21,13,22].…”

Relationship between BMI and CD4 cell counts among people living with HIV on ART attending Infectious Disease Hospital, Kano State

“…Numerous studies in the last ve years have shown an increase in the prevalence of obesity and overweight among HIV-positive people, particularly in Africa, with a clear correlation to HAART adherence [9]- [15]. Prior research has mostly focused on evaluating how weight affects immune cells in HIVuninfected people, with mixed results.…”