Short-term and long-term cardiovascular risk, metabolic syndrome and HIV in Tanzania.
To compare short-term and long-term cardiovascular disease (CVD) risk scores and prevalence of metabolic syndrome in HIV-infected adults receiving and not receiving antiretroviral therapy (ART) to HIV-negative controls.



A cross-sectional study including 151 HIV-infected, ART-naive, 150 HIV-infected on ART and 153 HIV-negative adults. Traditional cardiovascular risk factors were determined by standard investigations. The primary outcome was American College of Cardiology/American Heart Association Atherosclerotic CVD (ASCVD) Risk Estimator lifetime CVD risk score. Secondary outcomes were ASCVD 10-year risk, Framingham risk scores, statin indication and metabolic syndrome.



Compared with HIV-negative controls, more HIV-infected adults on ART were classified as high lifetime CVD risk (34.7% vs 17.0%, p<0.001) although 10-year risk scores were similar, a trend which was similar across multiple CVD risk models. In addition, HIV-infected adults on ART had a higher prevalence of metabolic syndrome versus HIV-negative controls (21.3% vs 7.8%, p=0.008), with two common clusters of risk factors. More than one-quarter (28.7%) of HIV-infected Tanzanian adults on ART meet criteria for statin initiation.



HIV-infected ART-treated individuals have high lifetime cardiovascular risk, and this risk seems to develop rapidly in the first 3-4 years of ART as does the development of clusters of metabolic syndrome criteria. These data identify a new subgroup of low short-term/high-lifetime risk HIV-infected individuals on ART who do not currently meet criteria for CVD risk factor modification but require further study.
Department of Internal Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania Department of Internal Medicine, Bugando Medical Centre, Mwanza, Tanzania Division of Hospital Medicine, Department of Internal Medicine, Weill Cornell Medical College, New York City, New York, USA Department of Internal Medicine, Center for Global Health, Weill Cornell Medical College, New York City, New York, USA.
Justin R
JR
Kingery
Department of Internal Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania Department of Internal Medicine, Bugando Medical Centre, Mwanza, Tanzania.
Yona
Y
Alfred
Department of Internal Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania Department of Internal Medicine, Bugando Medical Centre, Mwanza, Tanzania Department of Internal Medicine, Center for Global Health, Weill Cornell Medical College, New York City, New York, USA.
Luke R
LR
Smart
Department of Internal Medicine, Center for Global Health, Weill Cornell Medical College, New York City, New York, USA.
Emily
E
Nash
Population Health Department, London School of Hygiene & Tropical Medicine, London, UK.
Jim
J
Todd
Department of Medicine, Weill Cornell Medical College-Qatar, Doha, Qatar.
Mostafa R
MR
Naguib
Department of Internal Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania Department of Internal Medicine, Bugando Medical Centre, Mwanza, Tanzania Department of Internal Medicine, Center for Global Health, Weill Cornell Medical College, New York City, New York, USA.
Jennifer A
JA
Downs
Department of Internal Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania Department of Internal Medicine, Bugando Medical Centre, Mwanza, Tanzania.
Samuel
S
Kalluvya
Department of Internal Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania Department of Internal Medicine, Bugando Medical Centre, Mwanza, Tanzania.
Johannes B
JB
Kataraihya
Department of Internal Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania Department of Internal Medicine, Bugando Medical Centre, Mwanza, Tanzania Division of Hospital Medicine, Department of Internal Medicine, Weill Cornell Medical College, New York City, New York, USA Department of Internal Medicine, Center for Global Health, Weill Cornell Medical College, New York City, New York, USA.
Robert N
RN
Peck
D000328:Adult; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D013636:Tanzania / Q000453:epidemiology; D013997:Time Factors
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors