Prevalence and correlates of carotid plaque in a mixed HIV-serostatus cohort in Uganda.

Abstract

BACKGROUND:

The extent to which the risk of atherosclerotic cardiovascular disease (ACVD) is increased among people living with HIV (PLWH) in sub-Saharan Africa remains unknown.

SETTING:

Cross-sectional analysis nested within the Ugandan Noncommunicable Diseases and Aging Cohort, including PLWH in rural Uganda > 40 years taking antiretroviral therapy (ART) for at least 3 years, and a population-based control group of HIV-uninfected age- and sex-matched persons.

METHODS:

We conducted carotid ultrasonography and collected ACVD risk factor data. Our outcome of interest was carotid plaque, defined as > 1.5 mm thickness from the intima-lumen interface to the media-adventitia interface. We fit multivariable logistic regression models to estimate correlates of carotid plaque including HIV-specific and traditional cardiovascular risk factors.

RESULTS:

We enrolled 155 (50.2%) PLWH and 154 (49.8%) HIV-uninfected comparators, with a mean age of  51.4 years. Among PLWH, the median CD4 count was 433 cells/mm3 and 97.4% were virologically suppressed. Carotid plaque prevalence was higher among PLWH (8.4% vs 3.3%). HIV infection (aOR 3.90; 95% CI 1.12-13.60) and current smokers (aOR 6.60; 95% CI 1.22-35.80) had higher odds of carotid plaque, whereas moderate (aOR 0.13, 95% CI 0.01-1.55) and vigorous intensity of physical activity (aOR 0.34, 95% CI 0.07-1.52) were associated with decreased odds of carotid plaque.

CONCLUSION:

In rural Uganda, PLWH have higher prevalence of carotid plaque compared to age- and sex-matched HIV-uninfected comparators. Future work should explore how biomedical and lifestyle modifications might reduce atherosclerotic burden among PLWH in the region.

• Authors: Prossy Bibangambah, Linda C Hemphill, Moses Acan, Alexander C Tsai, Ruth N Sentongo, June-Ho Kim, Isabelle T Yang, Mark J Siedner, Samson Okello
• Journal: BMC cardiovascular disorders (BMC Cardiovasc Disord) Vol. 21 Issue 1 Pg. 593 (12 15 2021) ISSN: 1471-2261 [Electronic] England
• PMID: 34911457 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: © 2021. The Author(s).

Topics

• Adult
• Carotid Artery Diseases (diagnostic imaging, epidemiology)
• Carotid Intima-Media Thickness
• Case-Control Studies
• Cross-Sectional Studies
• Female
• HIV Infections (diagnosis, epidemiology, immunology)
• HIV Seronegativity
• HIV Seropositivity
• Humans
• Male
• Middle Aged
• Plaque, Atherosclerotic
• Predictive Value of Tests
• Prevalence
• Prospective Studies
• Risk Assessment
• Risk Factors
• Uganda (epidemiology)