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Evaluation of Cardiovascular Risk Profile and Risk Scores of Antiretroviral Therapy-naïve HIV Patients in Eastern
Manaswi Chaubey1, Jaya Chakravarty1, Rishabh Gupta1
1Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Insights
Cardiovascular disease (CVD) risk factors are common in people living with human immunodeficiency virus (PLHIV) not yet on treatment. Early screening and management of these factors are crucial for better health outcomes in PLHIV.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- People living with human immunodeficiency virus (PLHIV) have a higher risk of cardiovascular disease (CVD).
- Traditional CVD risk factors are more prevalent in PLHIV.
- This study focuses on treatment-naïve PLHIV to understand their specific CVD risk profile.
Purpose of the Study:
- To assess the prevalence of traditional cardiovascular disease (CVD) risk factors in treatment-naïve people living with human immunodeficiency virus (PLHIV).
- To calculate 10-year Framingham and atherosclerotic cardiovascular disease (ASCVD) risk scores in this population.
- To identify factors associated with increased CVD risk in treatment-naïve PLHIV.
Main Methods:
- A cross-sectional explorative study was conducted.
- 337 treatment-naïve PLHIV attending an antiretroviral therapy (ART) center were included.
- Traditional CVD risk factors, 10-year Framingham risk scores, and 10-year ASCVD risk scores were assessed.
Main Results:
- High prevalence of low high-density lipoprotein cholesterol (81.4%), high triglycerides (32.7%), and smoking (32.3%) were observed.
- Moderate-to-high 10-year Framingham and ASCVD risk scores were found in 10.8% and 8.9% of patients, respectively.
- Age ≥40 years, alcohol intake, and tuberculosis were associated with higher CVD risk in multivariate analysis.
Conclusions:
- Cardiovascular disease risk factors are prevalent in ART-naïve PLHIV.
- Screening, education, and treatment of CVD risk factors should be initiated at the start of care for PLHIV.
- Proactive management of CVD risk factors is essential for this vulnerable population.
Introduction:
People living with human immunodeficiency virus (PLHIV) are known to have an increased prevalence of traditional cardiovascular risk factors and are at a higher risk of cardiovascular disease (CVD). This study was done to assess the CVD risk factors in treatment naïve PLHIV in a center of the national program.
Methods:
In this cross-sectional explorative study, traditional CVD risk factors were assessed, and 10-year Framingham and atherosclerotic cardiovascular disease (ASCVD) risk score were calculated in treatment naïve PLHIV attending the antiretroviral therapy (ART) center, IMS, BHU.
Results:
The study included 337 ART naïve patients. The prevalence of CVD risk factors in treatment naïve PLHIV - were low high-density lipoprotein cholesterol levels (81.4%), high triglyceride levels (32.7%), smoking (32.3%), obesity (13.6%), hypertension (5%), diabetes (2.7%), and high low-density lipoprotein cholesterol levels (2.1%). Moderate-to-high 10-year Framingham Risk Score and American Heart Association/American College of Cardiology 10-year ASCVD risk score were 10.8% and 8.9%, respectively. In Framingham Risk Score, age ≥40 years (odds ratio [OR] - 131) (95% confidence interval [CI] - 6.5-1043) alcohol intake (OR - 5.14 [95% CI - 1.82-14.46] and presence of tuberculosis (OR - 4.78) (95% CI - 1.48-15.40), while in ASCVD risk score history of alcohol intake (OR - 26.20 [95% CI - 3.1-216.8] were at higher risk of CVD in multivariate variate analysis.
Conclusion:
CVD risk factors were common among ART naïve patient. Thus, screening, education, and treatment of CVD risk factors should be done in these patients at initiation of care.
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