Key result
HIV infection was associated with a significantly higher prevalence of carotid plaque compared to age- and sex-matched HIV-uninfected comparators (8.4% vs 3.3%, aOR 3.90).
Why the study?
The extent to which atherosclerotic cardiovascular disease risk is increased among people living with HIV in sub-Saharan Africa remains unknown.
Does HIV infection increase the prevalence of carotid plaque in adults over 40 years in rural Uganda?
Cross-Sectional (n=309)
Outcome assessor blinded
No
Does HIV infection increase the prevalence of carotid plaque in adults over 40 years in rural Uganda?
Odds Ratio: 3.9 (95% CI 1.12–13.6)
Absolute Event Rate: 8.4% vs 3.3%
p-value: p=0.033
In a rural Ugandan cohort, people living with HIV had a significantly higher prevalence of carotid plaque compared to age- and sex-matched HIV-uninfected individuals, suggesting an increased atherosclerotic burden.
HIV-associated carotid plaque increase warrants awareness in rural Uganda; hypothesis-generating and requires prospective validation before clinical adoption.
BACKGROUND: The extent to which the risk of atherosclerotic cardiovascular disease (ACVD) is increased among people living with HIV (PLWH) in sub-Saharan Africa remains unknown. SETTING: Cross-sectional analysis nested within the Ugandan Noncommunicable Diseases and Aging Cohort, including PLWH in rural Uganda > 40 years taking antiretroviral therapy (ART) for at least 3 years, and a population-based control group of HIV-uninfected age- and sex-matched persons. METHODS: We conducted carotid ultrasonography and collected ACVD risk factor data. Our outcome of interest was carotid plaque, defined as > 1.5 mm thickness from the intima-lumen interface to the media-adventitia interface. We fit multivariable logistic regression models to estimate correlates of carotid plaque including HIV-specific and traditional cardiovascular risk factors. RESULTS: and 97.4% were virologically suppressed. Carotid plaque prevalence was higher among PLWH (8.4% vs 3.3%). HIV infection (aOR 3.90; 95% CI 1.12-13.60) and current smokers (aOR 6.60; 95% CI 1.22-35.80) had higher odds of carotid plaque, whereas moderate (aOR 0.13, 95% CI 0.01-1.55) and vigorous intensity of physical activity (aOR 0.34, 95% CI 0.07-1.52) were associated with decreased odds of carotid plaque. CONCLUSION: In rural Uganda, PLWH have higher prevalence of carotid plaque compared to age- and sex-matched HIV-uninfected comparators. Future work should explore how biomedical and lifestyle modifications might reduce atherosclerotic burden among PLWH in the region.
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Bibangambah et al. (2021) conducted a cross-sectional in HIV infection (n=309). HIV infection vs. HIV-uninfected comparators was evaluated on Carotid plaque prevalence (> 1.5 mm thickness) (aOR 3.90, 95% CI 1.12-13.60, p=0.033). HIV infection was associated with a significantly higher prevalence of carotid plaque compared to age- and sex-matched HIV-uninfected comparators (8.4% vs 3.3%, aOR 3.90).
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