Prevalence and incidence of hypertension and diabetes mellitus in HIV infected persons on HAART in Chongwe district in Lusaka province.
The Zambia National strategic plan (ZNHSP)-2011-2017 highlights the need for risk factor stratification at the community level to form the basis of incidence and prevalence data, which are currently inadequate. This research aims to determine the prevalence and incidence of hypertension and diabetes among HIV infected patients on Highly Active Anti-Retroviral Therapy (HAART) and its association with ARVs use. A retrospective cohort study was used using the SMART CARE electronic database in Chongwe district to assess 2,070 HIV infected persons on HAART. Data was analyzed using SPSS version 20, and analyzed using Chi-square Kruskal-Wallis for analysis of variance, and logistic regression was used to establish the determinants of hypertension and type II diabetes mellitus among HIV infected persons on HAART. 33.8% HIV positive clients on HAART had hypertension, and an incident case fatality rate of 85.7 cases per 1000 PYFU of hypertension. The prevalence of hypertension was significantly higher (χ2=49.238, df=1; p<0.001) among men (64%) than among women (49%). The prevalence of hypertension also differed significantly (χ2=11.194, df=2; p=0.004) among different age categories and was highest (57.2%) among the 18-45 years age bracket. This study also found a significant correlation between hypertension and age of client in years (p=0.009). The study also found an incident rate of 37.4 cases per 1000 PYFU of T2DM. This study also established no significant differences in the prevalence of type II diabetes mellitus between women (26%) and men (23%). However, the prevalence of diabetes differed significantly ((χ2=10.043, df=2; p=0.007) among different age categories and was highest (27.5%) among the 56 years and older age bracket. Results of logistical regression analysis for the determinants T2DM and hypertension show that ART combination (p=0.001), age category (p=0.011) and cigarette smoking (p=0.0460) significantly added to the prediction model for T2DM outcome; and that ART combination (p=0.004), sex (p=0.001), family history of hypertension (p=0.007) and cigarette smoking (p=0.001) had significant associations with and significantly added to the prediction model for hypertension outcome. HIV positive clients on HAART had high prevalence and incidence of hypertension and type II diabetes mellitus. HAART combination regimen of two NRTI classes plus either a PI or INSTI were associated with higher incidence of hypertension whilst combination regimens of two NRTIs plus an NNRTI or INSTI and combination therapy of NRTI+NNRTI+INSTI were associated with higher incidence of type II diabetes mellitus in HAART treated clients.
Diabetes., Highly active antiretroviral therapy., HIV Persons--HAART.
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