Comparison of cardiometabolic factors and diseases in individuals with and without HIV infection in Sanpasitthiprasong Hospital: Age- and sex-matched cross-sectional analytical study

Abstract

Background: People living with HIV currently have longer life expectancy, with cardiovascular disease being a leading cause of death. However, there remains uncertainty over the association between HIV infection, antiretroviral therapy and cardiometabolic factors and diseases, and evidence in Asian populations is scarce. The present study aimed to compare cardiometabolic factors and diseases between people with and without HIV infection in a large tertiary hospital in Northeast Thailand.

Materials and Methods: In this 1:1 age- and sex-matched cross-sectional analytical study, medical records of individuals with and without HIV infection treated at the Department of Medicine, Sanpasitthiprasong Regional Hospital between March and May 2017, were reviewed. Data on sociodemographic, physical examination, cardiometabolic factors and diseases, including diabetes, hypertension, and coronary heart disease, were obtained and compared using chi-square test and independent t-test. The association between HIV infection and risk of cardiometabolic diseases was examined using multivariate logistic regression.

Results: Cardiometabolic factors and diseases in 635 individuals with HIV infection and 635 individuals without HIV infection were compared. HIV-infected individuals reported a higher prevalence of smoking and alcohol drinking, and had lower blood sugar, body mass index and systolic blood pressure than those without HIV infection. The prevalence of diabetes, hypertension and coronary heart disease was lower in those with HIV infection than those without (3.5% vs 12.6%, 15.4% vs 21.7%, 0.3% vs 2.8%; p-value <0.001, 0.004, <0.001 respectively), while dyslipidemia prevalence was similar. After controlling for other cardiovascular risk factors, HIV infection was significantly associated with a 71% and 88% decreased risk of diabetes and coronary heart disease (Adjusted odds ratio 0.29 (95% CI, 0.17-0.49) and 0.12 (95% CI, 0.03-0.56), p<0.05).

Conclusions: People with HIV infection appeared to have poorer cardiometabolic factors, but
lower risk of diabetes and coronary heart disease than those without. In addition to specific HIV
treatment, cardiovascular risk factors should also be effectively managed in order to prevent
cardiometabolic diseases.