TY - JOUR
T1 - Comparison of predicted cardiovascular risk profiles by different CVD risk-scoring algorithms between HIV-1-infected and uninfected adults: a cross-sectional study in Tanzania
AU - Msoka, Titus F.
AU - Rogath, Josephine
AU - Van Guilder, Gary P.
AU - Kapanda, Gibson
AU - Smulders, YM
AU - Tutu-van Furth, AM
AU - Bartlett, John A.
AU - van Agtmael, MA
N1 - Funding Information: The NUFFIC Scholarship programme, The Netherlands, and an International Fellows Program award from the University of W isconsin System supported this study . JB receives salary support from the US National Institutes of Health A wards P30AI64518, U01AI067854, D43CA153722, and D43TW06732, and from the Health Resources and Services Administration A ward T84HA21 123. Funding Information: The NUFFIC Scholarship programme, The Netherlands, and an International Fellows Program award from the University of Wisconsin System supported this study. JB receives salary support from the US National Institutes of Health Awards P30AI64518, U01AI067854, D43CA153722, and D43TW06732, and from the Health Resources and Services Administration Award T84HA21123. Publisher Copyright: © 2021 Msoka et al. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021
Y1 - 2021
N2 - Purpose: Cardiovascular disease (CVD) risk assessment is a suitable way to differentiate between high-risk individuals requiring intervention and risk modification, and those at low risk. However, concerns have been raised when adopting a CVD-risk prediction algorithm for HIV-infected patients in sub-Saharan Africa. Patients and Methods: We compared cardiovascular risk profiles between HIV-infected (with and without antiretroviral therapy (ART)) and HIV-uninfected adults as predicted by the American College of Cardiology/American Heart Association (ASCVD) and the Framingham cardiovascular risk score (FRS) algorithms and assessed the concordance of the algorithms in predicting 10-year CVD risk separately in HIV-infected and uninfected groups in a hospital-based cross-sectional study in Tanzania. A cross-sectional hospital-based study including 40 HIV-infected ART-naive, 64 HIV-infected on ART, and 50 HIV-uninfected adults was conducted. Traditional cardiovascular risk factors were determined by standard investigations. The primary outcome was the absolute 10year CVD risk score based on the two algorithms. Results: Compared to HIV-uninfected, HIV-infected adults were classified at a higher 10year CVD risk. ASCVD algorithms predicted a higher proportion of high-risk individuals compared to FRS in both HIV-infected and uninfected groups. The concordance between ASCVD and FRS-lipid algorithms was reasonable for both HIV-infected and uninfected groups though relatively higher in the HIV-uninfected group. Conclusion: HIV-infected individuals have a higher 10-year cardiovascular risk compared to HIV-uninfected persons. The concordance between ASCVD and FRS-lipid algorithms is reasonable in both HIV-uninfected and infected persons in Tanzania. Development of an HIV-specific algorithm is needed to accurately predict CVD risk in this population at highrisk.
AB - Purpose: Cardiovascular disease (CVD) risk assessment is a suitable way to differentiate between high-risk individuals requiring intervention and risk modification, and those at low risk. However, concerns have been raised when adopting a CVD-risk prediction algorithm for HIV-infected patients in sub-Saharan Africa. Patients and Methods: We compared cardiovascular risk profiles between HIV-infected (with and without antiretroviral therapy (ART)) and HIV-uninfected adults as predicted by the American College of Cardiology/American Heart Association (ASCVD) and the Framingham cardiovascular risk score (FRS) algorithms and assessed the concordance of the algorithms in predicting 10-year CVD risk separately in HIV-infected and uninfected groups in a hospital-based cross-sectional study in Tanzania. A cross-sectional hospital-based study including 40 HIV-infected ART-naive, 64 HIV-infected on ART, and 50 HIV-uninfected adults was conducted. Traditional cardiovascular risk factors were determined by standard investigations. The primary outcome was the absolute 10year CVD risk score based on the two algorithms. Results: Compared to HIV-uninfected, HIV-infected adults were classified at a higher 10year CVD risk. ASCVD algorithms predicted a higher proportion of high-risk individuals compared to FRS in both HIV-infected and uninfected groups. The concordance between ASCVD and FRS-lipid algorithms was reasonable for both HIV-infected and uninfected groups though relatively higher in the HIV-uninfected group. Conclusion: HIV-infected individuals have a higher 10-year cardiovascular risk compared to HIV-uninfected persons. The concordance between ASCVD and FRS-lipid algorithms is reasonable in both HIV-uninfected and infected persons in Tanzania. Development of an HIV-specific algorithm is needed to accurately predict CVD risk in this population at highrisk.
KW - Antiretroviral therapy
KW - Atherosclerotic cardiovascular disease risk score
KW - Framingham risk score
KW - Kilimanjaro Christian Medical Center
KW - Moshi
UR - http://www.scopus.com/inward/record.url?scp=85108239232&partnerID=8YFLogxK
U2 - https://doi.org/doi: 10.2147/HIV.S304982
DO - https://doi.org/doi: 10.2147/HIV.S304982
M3 - Article
SN - 1179-1373
VL - 13
SP - 605
EP - 615
JO - HIV/AIDS (Auckland, N.Z.)
JF - HIV/AIDS (Auckland, N.Z.)
ER -