A 10-year follow-up study of demographic and cardiometabolic factors in HIV-infected South Africans

Cardiovasc J Afr. 2019;30(6):352-360. doi: 10.5830/CVJA-2019-034. Epub 2019 Aug 2.

Abstract

Objectives: Understanding of the interplay between human immunodeficiency virus (HIV) and cardiovascular disease, especially in Africa, is limited to evidence from longitudinal studies. Therefore the demographic profile and cardiometabolic, renal and liver function of an HIV-infected South African population were profiled from 2005 to 2015.

Methods: The study included 117 HIV-infected and 131 uninfected controls that were examined at baseline, five and 10 years.

Results: Mortality rate declined from 24% (2005-2010) to 0% (2010-2015) after the introduction of ART. Longitudinal increases in C-reactive protein (p = 0.002), alanine transaminase (p = 0.006) and gamma-glutamyl transferase (p = 0.046) levels and estimated glomerular filtration rate (p < 0.001) were seen only in the HIV-infected group. This group also showed increased high-density lipoprotein cholesterol (HDL-C) (p < 0.001) and total cholesterol (p < 0.001) levels and decreased triglyceride:HDL-C (p = 0.011) levels. Low-density lipoprotein cholesterol decreased in both groups (p < 0.001).

Conclusions: Despite trajectories of deranged lipid and inflammatory profiles, the cardiometabolic disease risk seems stable in HIV-infected South Africans. Inflammation and renal and liver function warrant regular monitoring.

Keywords: South Africa; antiretroviral therapy; cardiometabolic factors; human immunodeficiency virus; liver enzymes; renal function.