Hypertension in HAART-Naïve HIV Subject in Southeast Nigeria: A Single-Center Study

Abstract

Background: Hypertension is a major healthcare problem in Nigeria with a probable prevalence of 36.6%. Human immunodeficiency virus (HIV) infection  is a global healthcare problem. The factors which influence hypertension in HIV subjects have not been completely identified. The study aimed to  determine the prevalence of hypertension and the factors which might influence hypertension in HAART-naïve HIV subjects.

Methodology: This was a cross-sectional study involving 393 treatment-naïve HIV subjects and 136 age and sex-matched HIV seronegative controls.  Anthropometric and demographic data were obtained, blood pressure measurements and other relevant investigations were performed. Hypertension  was defined here as systolic blood pressure (SBP) ≥ 140mmHg and diastolic blood pressure (DBP) ≥ 90mmHg. Hypertension was compared between the  HIV subjects and the non-HIV control. The association of the variables with hypertension in HIVsubjects were determined.

Results: The mean age of the HIV subjects was 39±11 years. Females were 282(72.0%) and males 110(28.0%). The prevalence of hypertension was 23.7%  in HIV subjects and 31.6% in the non-HIV control. The prevalence of hypertension was 17.2% in HIV subjects with high density lipoprotein cholesterol  (HDL) <1.0mg/dl and this was significantly lower than the prevalence of hypertension of 27.1% in those whose serum HDL was ≥ 1.0mg/dl. There was no  significant association between hypertension and 24-hour urine osmolality (24HUOsm) (p=0.094), body mass index (BMI) (p=0.572), 24-hour urine protein  (24HUP) (p=0.606), serum total cholesterol (p=0.628), serum low density lipoprotein cholesterol (LDL) (p=0.116), triglyceride (TG) (p=0.925), Systolic blood  pressure had a significant correlation with serum HDL, (r=0.114, p=0.024). Similarly, CD4 cell count correlated significantly with DBP (r=0.123, p=0.012.  Serum HDL(p=0.0.024) and CD4 cell count (p=0.012) predicted hypertension in HIV subjects.

Conclusion: The prevalence of hypertension of 23.7% in HIV subjects was high in this study. Low CD4 cell count and low serum HDLwere predictors of  hypertension in HIVsubjects.