Metabolic and Cardiovascular Comorbidities Among Clinically Stable HIV Patients on Long-Term ARV Therapy in Five Ambulatory Clinics in Lima-Callao, Peru

Abstract

Background:There is scarcity of data about the prevalence of non-AIDS defining comorbidities among stable HIV-infected patients in Peru.Objective:We aimed to describe the most frequent cardiometabolic comorbidities found among ambulatory adults on ARV in Peru.Methods:A review of records for patients attending regular visits at 5 clinics in Lima-Callao in January-February 2016 is presented. Patients were adults on ARV for >6 months, with no recent AIDS-defining condition.Results:Three hundred and five medical charts were reviewed. Most patients were male (73.1%, n=223) with a mean age of 46.0 years. Mean time from HIV diagnosis was 9.41 yrs. and mean duration of ARV was 7.78 yrs. Most patients were on an NNRTI-based first line regimen (76.4%, n=233), and 12.1% (n=37) were on rescue regimens. Median CD4 count was 614.2 cells/µL and the proportion of patients with viral load <40 c/mL was 90.8% (n=277). Most frequent metabolic diagnoses were dyslipidemia (51.5%, n=157), obesity (11.1%, n=34), and diabetes mellitus (7.2%, n=22). Hypertension was diagnosed in 8.9% (n=27). Other diagnoses of cardiovascular disease were documented in 3.3% (n=10). Pharmacologic treatment was prescribed in 91.3% of patients with diabetes or hypertension, but in only 29.3% of patients with dyslipidemia.Conclusion:A high proportion of metabolic comorbidities was found, with dyslipidemia being the most frequent, followed by obesity and diabetes. In contrast, cardiovascular disease was documented less frequently. Medical treatment was started for only a third of dyslipidemia patients. HIV care policies need to consider proper management of chronic comorbidities to optimize long-term outcomes.

Weight gain post-ART in HIV+ Latinos/as differs in the USA, Haiti, and Latin America

“… 9 In a cohort of PWH from Rio de Janeiro, Brazil, obesity prevalence was 5% in 2000–2003 and 12% in 2012–2015. 6 In Lima-Callao, Peru, in 2016, among PWH initiating ART in 5 clinics, obesity prevalence was 11% 10 and in the Dominican Republic in 2012, obesity prevalence among PWH was 14%. 11 …”

Frequency of non-communicable diseases in people 50 years of age and older receiving HIV care in Latin America

“…While the frequency of NCDs among aging PLWHIV has been extensively studied in the USA, Europe, and Africa [4][5][6][18][19][20], few studies have addressed this emerging problem in Latin America [21][22][23][24][25]. Published data from single-center cohorts of people older than 50 receiving care for HIV in Mexico and Brazil found high prevalence of (DM, 20-22%), HTN (33-62%), dyslipidemia in Mexico (57%), and chronic liver (25%) and kidney disease (16%) in Brazil.…”

Cardiovascular Risk Factors in Mexican People Living with HIV Under Cart with a High Prevalence of Overweight

“…Globally, it is estimated that the metabolic syndrome in the HIV-seropositive population is 29.6% (according to the ATPIII criteria), which is similar to that of a population not infected with HIV (54). Approximately 46.2% of our studied population was in overweight/obesity status, although still lower that an HIV-seropositive population from Peru which presented 52.70% (55). In a study in several populations from Latin America (Venezuela, Brazil, Colombia, Peru and Ecuador), in which PLWHA showed a high prevalence of metabolic syndrome, and 44% of the participants were under IP treatment (56).…”