Prevalence and risk factors of peripheral artery disease in black Africans with HIV infection: a cross-sectional hospital-based study

Abstract

BackgroundThe prevalence of peripheral artery disease (PAD) is not well known among HIV-infected patients in Africa. The aim of this study was to determine the prevalence and associated risk factors of PAD among HIV-infected patients at the Douala General Hospital (DGH).MethodsThis was a cross-sectional descriptive and analytic study between November 2015 and April 2016. We recruited patients aged ≥21 years, diagnosed with HIV infection, and who were receiving care at the DGH. We collected sociodemographic data and past medical history of patients. We measured their ankle-brachial index (ABI). We defined PAD as an ABI <0.9. We also measured their fasting blood glucose and lipid profile.ResultsWe recruited 144 patients for this study. The mean age was 46±9 years, and 72.2% were females. Of which, 89% were on antiretroviral treatment (ARV). Their mean CD4+ T lymphocytes count was 451±306 cells/mm3. Their mean ABI was 1.12±0.17 and 1.07±0.11, respectively, on the left and right legs (P>0.05). The prevalence of PAD was 6.9% (95% CI: 3.4–12.4), and 60% of patients with PAD were symptomatic. After adjusting for age, sex and ARV, ARV treatment was protective (aOR: 0.18, [95% CI: 0.04–0.82], P=0.034), while WHO stages III or IV was associated with PAD (aOR: 11.1, [95% CI: 2.19–55.92], P=0.004).ConclusionThe prevalence of PAD was not as high as expected in this group of patients with high cardiovascular risk infected with HIV. Advanced HIV disease was associated with PAD, while ARV was protective.

HIV clinical stages and lower extremity arterial disease among HIV infected outpatients in Burundi

“…The prevalence of LEAD in the general population has been estimated between 2 and 4% in two large studies in young adults in USA 24 , 25 . In a cross-sectional hospital-based study in black Africans, the LEAD prevalence was estimated at 6.9% 14 . A recent Nigerian study reported no difference of LEAD prevalence between virologically-suppressed individuals and controls 19 .…”

“…This association has also been described, in hospital Spanish and Cameroon populations. These studies had either important LEAD diagnosis bias 14 or exclusively focused on asymptomatic LEAD subjects 17 . Our results accurately analysed the association between HIV clinical stage and LEAD in urban and rural HIV outpatients and indicate that the severity of HIV infection could influence the arteries injury.…”

“…Nevertheless, few specific studies assessed the prevalence of LEAD among PLWH. Available data are issued from studies in hospitalized patients 13 , 14 , urban population 15 or age limited populations, using heterogenous definition of LEAD 14 , 16 or focusing on specific clinical LEAD stages 17 . Results are controversial 18 , 19 as study populations are not comparable.…”

Subclinical atherosclerosis and associated risk factors among hiv-infected adults in Jos, North Central Nigeria: a cross-sectional study

“…HIV is fast gaining reputation as a leading cause of CVDs in sub-Saharan Africa (SSA) [ 3 , 4 ]. In addition to the usual risk factors for CVDs in the general populations, People Living with HIV (PLHIV) may have addition risk factors related to endothelial dysfunction, metabolic effects of antiretroviral drugs such as dyslipidemias, insulin resistance and the chronic inflammation induced by Human Immunodeficiency Virus (HIV) which heighten their predisposition to CVDs [ 5 , 6 ]. The burden of HIV remains high in SSA and Nigeria is among the countries with the highest prevalence with about 3.5 million people infected [ 7 ].…”

“…It involves a complex pathophysiologic process resulting in deposition of fatty materials, thickening of the intima and narrowing of blood vessels. The combination of endothelial dysfunction, chronic inflammation and dyslipidemias are central to the pathogenesis of atherosclerosis and these conditions have been documented in HIV-infected patients [ 5 , 6 , 9 ]. The presence of subclinical atherosclerosis (SCA) which can be assessed by carotid intimal media thickness (CIMT) is a harbinger for CVDs [ 10 - 12 ].…”