Atherogenic risk assessment of naive HIV-infected patients attending Infectious Diseases Service of Kinshasa University Teaching Hospital, Democratic Republic of the Congo (DRC)

Abstract

Background and aim: Metabolic abnormalities are common in HIV/AIDS. Increasingly, lipid ratios are used as screening tools for dyslipidaemia in these medical conditions. The aim of this study was to assess the ability of 4 lipid ratios to predict cardiovascular risks. Methods: This is a cross-sectional and analytical study included 105 HIV+ patients followed in Kinshasa University Teaching Hospital (KUTH). Four indices [Atherogenic Index of Plasma (AIP), Castelli Risk Index (CRI) I and II, Atherogenic coefficient (AC)] were compared. Statistical analyzis consisted of measuring frequencies and means, Student’s t-tests, ANOVA and Ficher’s exact test, and the calculation of the Kappa value. Results: Lipid ratios predicted respectively the risk in 62% (AIP), 28.6% (CRI-I) and 23.8% (CRI-II). CRI-I and II were elevated, especially in women. The AIP appeared to be a better predictor than CRI-I and II to assess dyslipidaemia in general and the high-risk frequency. The cholesterol detected risk in 66.7% (Low HDL-C), 50% (High LDL-C), 38.9% (High TC and/or TG). The atherogenic risk was higher with age, advanced WHO stage, HIV-TB, HBV-HCV co-infections, smoking and alcohol intake. Haemoglobin (Hb) and CD4 counts were low when the risk was high. Age ≥ 50 years, stage 4 (WHO), CD4s+ ≤ 200 cells/µL were independent factors associated with atherogenic risk. Conclusion: Lipid ratios can be used as reliable tools for assessing cardiovascular risk of naïve HIV-infected patients who received HAART.

Étude interventionnelle sur le Dolutégravir et les autres antirétroviraux dans l´athérosclérosclérose infra-clinique en milieu hospitalier de Kinshasa

“…Malgré l'existence d'un traitement très efficace permettant aux personnes vivant avec le virus de l'immunodéficience humaine (PVVIH) de mener une vie relativement normale, l'inflammation chronique persiste et est à l'origine du développement prématuré de comorbidités liées à l'âge, telles que les maladies cardiovasculaires (MCV) comme l'athérosclérose. Le niveau socio-économique bas, non seulement limite l´accès à l´instruction, aux soins et à la formation sur les moyens de prévention contre les maladies transmissibles [ 46 ] mais aussi augmente le risque d´adoption de comportement sexuel à risqué [ 46 , 47 ]. Le ratio CT/HDL-c a été suggéré comme un risque athérogène statistiquement important [ 24 , 25 ].…”