Prevalence and correlates of carotid plaque in a mixed HIV‑serostatus cohort in Uganda
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Cardiovascular Disorders
Abstract
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.
Description
Keywords
HIV, Carotid intima media thickness, Carotid plaque, Atherosclerosis, Cardiovascular disease
Citation
Bibangambah, P., Hemphill, L. C., Acan, M., Tsai, A. C., Sentongo, R. N., Kim, J. H., ... & Okello, S. (2021). Prevalence and correlates of carotid plaque in a mixed HIV-serostatus cohort in Uganda. BMC Cardiovascular Disorders, 21(1), 1-7. https://doi.org/10.1186/s12872-021-02416-5