Trends & predictors of non-AIDS comorbidities among people living with HIV and receiving antiretroviral therapy in Lebanon

Abstract

Combined antiretroviral therapy (cART) increased the life expectancy of people living with Human Immunodeficiency Virus (HIV) (PLHIV) and remarkably reduced the morbidity and mortality associated with HIV infection. Consequently, PLHIV are experiencing non-acquired immunodeficiency syndrome (AIDS) associated comorbid conditions including diabetes, hyperlipidemia, hypertension, and cardiovascular disease. The aim of this study is to determine the frequency of non-AIDS associated comorbid conditions among a cohort of PLHIV on cART in Lebanon. Data were collected between November 2018 and December 2019 from 105 voluntary participants. A standardized questionnaire was used to collect demographic and behavioral data including lifestyle, smoking, physical activity, substance use and abuse in addition to co-infections and family history of non-communicable diseases. Moreover, data on occurrence and treatment of cardiovascular disease, hypertension, diabetes, lipid and metabolic disorders as well as mental health were collected. Blood samples were used to assess the levels of fasting blood sugar (FBS), glycosylated hemoglobin (HbA1C), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein, total cholesterol, and serum creatinine. Hypertension (29.5%) and hyperlipidemia (29.5%) followed by diabetes (23.7%) and cardiovascular disease (9.7%) were mainly reported among study participants. Higher rate of comorbid conditions was observed among participants >40 years of age than those ≤40 years with both hypertension and hyperlipidemia most commonly reported. Older age (odds ratio [OR] 7.6; 95% CI: 1.83-31.98; P = .005) is associated with higher odds of having hyperlipidemia. Moreover, participants on cART for ≥10 years are 5 times more likely to have hyperlipidemia (OR 5; 95% CI: 1.08-22.73; P = .039). Our results also showed that study participants did not experience anxiety, depression or somatic symptoms and that there was no association between these mental disorders and older age or comorbidities. Our results provide important information on HIV trends and associated comorbidities in Lebanon and can be used to improve the management of non-communicable diseases among PLHIV.

Pulmonary Arterial Hypertension Associated with Portal Hypertension and HIV Infection: Comparative Characteristics and Prognostic Predictors

“…Regarding outcomes, we observed that their survival is similar to that of patients with only portal hypertension (who, however, have a non-statistically significant trend towards a worse prognosis, probably in relation to their older age that is, actually, one of their independent prognostic factors in our study) or HIV infection, despite the double pathogenetic noxa. Moreover, their survival was mainly related to the hepatic disease rather than to HIV infection, probably because HAART was prescribed in most of the patients and it is known that HAART can effectively reduce the mortality risk beyond improving the quality of life and the risk of opportunistic infections [38]. Instead, despite the improvements in the treatment of patients with portal hypertension, OLT frequently remains the only definitive treatment, but it may unfortunately be contraindicated by PAH itself or, in patients achieving a permissive hemodynamic profile, may be at least at an increased perioperative risk [39,40].…”

Factors Influencing Survival Status of HIV/AIDS after HAART in Huzhou City, Eastern China

“…HAART can effectively reduce the mortality risk of HIV/AIDS, improve quality of life, and reduce the risk of opportunistic infections [ 8 , 9 ]. The main purpose of HAART for patients is to inhibit the replication of HIV, reduce the viral load to the lower limit of detection, increase the CD4 + T lymphocyte count (CD4), rebuild or maintain immune function, prolong survival, and improve the quality of life [ 10 ].…”