Epidemiology of Coronary Atherosclerosis among People Living with HIV in Uganda: A Cross-Sectional Study
Abstract
Background HIV is an established risk factor for coronary atherosclerotic disease (CAD) in the United States and Europe, but data in the African region are lacking. Objective To determine whether well-controlled HIV infection in Uganda is associated with increased presence or severity of CAD. Design Cross-sectional cohort study. Setting Southwestern Uganda. Participants People over 40 years of age, living with HIV, and on antiretroviral therapy (ART) for 3+ years, and population-based, age- and sex-similar people without HIV (PWoH). Measurements Participants underwent cardiovascular disease (CVD) risk profiling and computed tomography (CT) for detection of CAD, defined as presence of calcified or non-calcified plaque. Results 586 participants met inclusion criteria and had evaluable images. Of these, 287 (49.0%) were PWH and nearly all (272/287, 97%) were virologically suppressed. Prevalence of CAD was low overall (54/586, 7.7%) and similar between PWH (26/287, 9.1%) and PWoH (19/299, 6.4%; absolute prevalence difference 2.7%, 95%CI −1.6, 7.0%). Findings were similar in multivariable regression models adjusted for CVD risk factors (adjusted prevalence ratio for PWH vs. PWoH 1.57, 95%CI 0.90, 2.74, P=0.11). Limitations Our findings may not generalize to symptomatic populations or those with known CAD. We cannot exclude residual confounding between HIV and CAD, and we may have inadequate power to detect increased prevalence of CAD. Conclusion We found no difference in the…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 586 participants or records.
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