Prevalence and correlates of traditional risk factors for cardiovascular disease in a Nigerian ART-naive HIV population: a cross-sectional study.

OBJECTIVES: HIV infection environment presents a classic example of the interplay between infectious diseases and non-communicable diseases (NCDs). Traditional cardiovascular disease (CVD) risk factors abound in the HIV population even before initiation of antiretrovirals (ARVs) and predispose them to the development of stroke and myocardial infarction. This work focuses on determining the prevalence of traditional CVD risk factors among ARV-naive HIV individuals in southern Nigeria. METHODS: This was a cross-sectional study of ARV-naive patients initiating care at the University of Uyo Teaching Hospital HIV clinic cohort to determine the prevalence and correlates of hypertension, diabetes mellitus (DM), obesity and dyslipidaemia. RESULTS: The sample consisted of 4925 assessed for hypertension, 5223 for obesity, 1818 for DM and 926 for dyslipidaemia. Hypertension prevalence was 26.7% (95% CI 25.5% to 28.0%) with a male preponderance (p=0.02). DM was found in 5.6% (95% CI 4.5% to 6.7%), obesity in 8.3% (95% CI 7.6% to 9.1%) and dyslipidaemia in 29.1% (95% CI 26.1% to 32.1%) with a high prevalence of low high-density lipoprotein-c (42.6%). Hypertension was independently associated with age (OR 1.04 (95% CI 1.03 to 1.05), p<0.001) and body mass index (BMI) (OR 1.06 (95% CI 1.03 to 1.08), p<0.001), obesity with age (OR 1.02 (95% CI 1.01 to 1.03), p<0.001), male gender (OR 0.38 (95% CI 0.29 to 0.49), p<0.001) and CD4 count (OR 2.63 (95% CI 1.96 to 3.53), p<0.001) while dyslipidaemia was associated with BMI (OR 1.05 (95% CI 1.01 to 1.10), p=0.03). CONCLUSION: The prevalence of traditional CVD risk factors is high in this ART-naive HIV population. An integrated approach of HIV and NCD screening/treatment may be relevant for centres in sub-Saharan Africa.

Prevalence and correlates of chronic kidney disease (CKD) among ART-naive HIV patients in the Niger-Delta region of Nigeria.

Widespread use of antiretroviral therapy (ART) in human immunodeficiency virus (HIV) patients has led to improved longevity with the attendant increase in noncommunicable disease prevalence including chronic kidney disease (CKD). This study documents the prevalence of CKD in a large HIV population in Southern Nigeria.This is a single center, 15-year analysis in ART-naïve patients. CKD was defined as the occurrence of estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m on 2 consecutive occasions 3 to 12 months apart using the chronic kidney disease epidemiology collaboration (CKD-EPI) equation. The Cochran-Armitage and Cuzick tests were employed to assess for trend across the years for CKD prevalence and CD4 count, respectively. Multivariable logistic regression models were used to identify independent associations with CKD.In all, 1317 patients (62.2% females) with mean age of 34.5 years and median CD4 count of 194 cells/µL were included. CKD prevalence was 13.4% (95%CI 11.6%-15.4%) using the CKD-EPI equation (without the race factor). Multivariable analysis identified increasing age and CD4 count <200 cells/µL as being independently associated with CKD occurrence.This study reports a high prevalence of CKD in ART-naïve HIV-infected patients. Measures to improve diagnosis of kidney disease and ensure early initiation of treatment should be integrated in HIV treatment programmes in this setting.

Prevalence and correlates of hypertension among the Ibibio/Annangs, Efiks and Obolos: a cross sectional community survey in rural South-South Nigeria.

OBJECTIVE: The objective of the study was to assess the public health burden of hypertension in the rural communities in southeastern Nigeria (Niger Delta region of Nigeria). DESIGN/SETTING: The study was a cross-sectional study in three rural communities in the Cross River and Akwa Ibom States of Nigeria. Demographic, anthropometric information, prior history of hypertension or stroke in each participant or their parents was obtained with a questionnaire. Height, weight, systolic blood pressure (SBP), and diastolic blood pressure (DBP) of respondents were measured by standard methods, and body mass index calculated. RESULT: The N of respondents was 3869; 1608 (41.6%) males, 2261 (58.4%) females; 1120 (29.0%) Efiks, 1877 (48.5%) Ibibio/Annangs, and 872 (22.5%) Obolos. Mean SBP and DBP were significantly higher in males than in females (P < .001). Prior awareness of hypertension was 2.8%. The overall prevalence of hypertension was 914 (23.6%); 31.2% males and 18.1% females (P < .001). The prevalence of hypertension in the ethnic groups was 479 (25.5%) among Ibibio/Annangs; 287 (25.6%) among the Efiks and 130 (14.9%) among the Obolos. Prehypertension occurred in 17.2% of total population, 17.5% males and 16.9% females (P = .66). CONCLUSION: Hypertension is already a major public health burden in rural communities of these two states, despite a very low incidence of obesity and cigarette smoking.

Quality of life in people living with HIV/AIDS in Niger Delta Region, Nigeria.

BACKGROUND: Despite the global efforts and huge financial investment in HIV/AIDS, the quality of life in people living with the disease continues to deteriorate, posing serious problems with increased mortality. AIM: The objectives of the study were: (i) to assess the quality of life in people living with HIV/AIDS, and (ii) to compare quality of life in males and females living with the disease. METHODS: A total of 309 people living with HIV/AIDS from the HIV clinic, University of Uyo Teaching Hospital were randomly assessed for quality of life, using HIV/AIDS-Targeted Quality of life (HAT-QOL) questionnaire. RESULTS: A total of 265 (85.8%) respondents consisting of 113 (36.6%) males and 152 (49.2%) females were analyzed. The mean age for males was 36.8 +/- 4.0 years and females 31.9 +/- 3.3 years. The difference in mean was statistically significant (t = 31.831, p < 0.01), occupation was statistically significant (chi(2) = 11.348, p < 0.02). Females showed lower quality of life in comparable domains than males. The differences in life satisfaction (chi(2) = 10.362, p < 0.01) and health worries (chi(2) = 9.944, p < 0.01) were statistically significant. CONCLUSION: The results showed impairment in quality of life, except in medication worries and sexual function in people living with HIV/AIDS. Improvement in HAT-QoL indices will enhance positive quality of life.