Level of Cardiovascular Disease Risk and Associated Factors among Clients on Highly Active Antiretroviral Therapy in Vihiga County, Kenya

Abstract

Context: HIV/AIDS is still a public health concern globally, especially in sub-Saharan Africa and Kenya. HIV-positive clients are initiated on highly active antiretroviral therapy (HAART) to reduce the multiplication of HIV and improve their immunity. These clients are at an increased cardiovascular disease risk due to a complex interplay of factors, including traditional cardiovascular risk factors such as smoking cigarettes, obesity due to inactivity, and diabetes.

Aim: This study sought to determine the level of cardiovascular disease (CVD) risk factors among people living with HIV (PLHIV) on highly active antiretroviral therapy (HAART) in Vihiga County, Kenya.

Methods: The study employed a cross-sectional survey design to report baseline survey data for an interventional study on the level of CVD risk factors. The study involved a systematic sample of 211 patients on HAART in six health facilities purposively selected from Vihiga County. Data was collected using the WHO STEPWISE questionnaire from six comprehensive care clinics in Vihiga County from March to July 2022. The World Health Organization-International Society of Hypertension (WHO-ISH) tool AFRI E CHART was used to estimate the cardiovascular risk.

Results: The majority (96.68%) of PLWHIV on HAART in Vihiga county had low overall cardiovascular risk as predicted WHO/ISH score. Age (OR = 1.199, 95% CI [1.031, 1.394], p = 0.018) and smoking status (OR = 0.115, 95% CI [0.024, 0.558], p = 0.007) exhibited a significant association with the level of cardiovascular risk.

Conclusion: The majority of PLHIV have a low estimated CVD risk. There is a need to prioritize weight management in HIV care, integrating healthy lifestyle behaviors and nutritional support while conducting regular cardiovascular risk assessments, focusing on modifiable factors like smoking. Age-specific interventions can also help mitigate the risk across the different age groups.