Metabolic comorbidities and systemic arterial hypertension: the challenge faced by HIV patients on long-term use of antiretroviral therapy

• Published in: Hospital practice (1995) Vol. 50; no. 1; p. 75
• Main Authors: Mendicino, Cássia Cristina Pinto, Moreira Costa, Alícia Amanda, da Silva, Gabriella Jomara, Braga, Letícia Penna, Rocha, Gustavo Machado, Carmo, Ricardo Andrade, Guimarães, Mark Drew Crosland, de Pádua, Cristiane A Menezes
• Format: Journal Article
• Language: English
• Published: England 2022
• Subjects: Adolescent; Adult; Comorbidity; Cross-Sectional Studies; HIV Infections - drug therapy; HIV Infections - epidemiology; Humans; Hypertension - drug therapy; Hypertension - epidemiology; Male; Quality of Life; metabolic alterations; chronic comorbidities; dyslipidemia; HIV monitoring; HIV antiretroviral therapy; physical activity
• DOI: 10.1080/21548331.2022.2030564
• ISSN: 2154-8331

Our objective was to estimate the frequency of comorbidities and assess its relationship with exposure factors after long-term ART use. A cross-sectional study with PLHIV (≥18 years-old), who initiated ART between 2001 and 2005 and attended an HIV/AIDS public referral center (Belo Horizonte/Brazil), was performed. Demographic, clinical, therapeutic, and lifestyle data were obtained through interviews, medical charts, public database, routine laboratory examinations, and bone densitometry. The outcome was the number of comorbidities: hyperglycemia, dyslipidemia, systemic arterial hypertension (SAH), and low bone mineral density (BMD). Absolute/relative frequencies were calculated. Factors associated with the outcome were assessed by quasi-Poisson regression. RESULTS: Of the 98 participants, 53% were male and 79% and over 43 years-old. Moderate physical activity was observed in 82%, overweight/obesity in 50%, and 58% used ART based on two nucleoside reverse transcriptase inhibitors (NRTIs) plus one non-nucleoside reverse transcriptase inhibitor (NNRTI). After a mean of 15.6 years of ART exposure, 207 comorbidities were identified and 93% participants presented at least one comorbidity (mean = 2.1/participant). The most frequent overlapping constituted two co-occurrences: dyslipidemia + hyperglycemia or dyslipidemia + SAH, n = 36 for each co-occurrence. The quasi-Poisson regression showed an increase of 3% in the number of comorbidities per year of age (OR = 1.03; 95%CI = 1.02-1.04) and 84% among PLHIV on moderate physical activity (ref = heavy physical-activity) (OR = 1.84; 95%CI = 1.08-3.13). Our study shows that the aging slightly contributed to comorbidities. However, the practice of physical-activities is crucial to prevent chronic-diseases. Treatment and preventive measures should be encouraged to diminish the burden of disease and improve quality of life among PLHIV.