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Copy of Cardiovascular Risk Factors and Cardiovascular Risk in People Living with HIV: Comparison of Four Cardiovascular Risk Prediction Algorithms

Keywords

Cardiovascular risk, HIV, Framingham, D.A.D , SCORE, Togo.

Research Identity (RIN)

Journal

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Attribution 2.0 Generic (CC BY 2.0)

English

Abstract

Introduction: The objective of our study was to evaluate, in a population of Togolese P eople Living With HIV(PLWHIV), the agreement between three scores derived from the general population namely the Framingham score, the Systematic Coronary Risk Evaluation (SCORE), the evaluation of the cardiovascular risk (CVR) according to the World Health Organization (WHO) and the CVR evaluation equation derived from the Data collection on Adverse effects of anti-HIV Drugs (D.A.D). Methods: We conducted a descriptive and analytical cross-sectional study including 212 HIV-infected patients recruited from the day hospital of the Infectious Diseases Department of the Sylvanus Olympio University Hospital. The level of agreement between the different scores was estimated using the Pearson correlation test and the Cohen Kappa coefficient. Results: The median age of the participants (68.9% female) was 50.2 years (IQR: 44.8-56.0). Eighty-seven point sevenpercent of the participants were on highly active antiretroviral therapy, 87.1% of whom were on a combinationof two nucleoside inhibitors and one non-nucleoside inhibitor. The most represented cardiovascular risk factors were abdominal obesity (56.1%), HDL hypocholesterolemia (52.4%) and hypertension (44.8%). The median cardiovascular risk was 6.3% (IQR: 3.9% -11.2%), 0.0% (IQR: 0.0% -1.0%), 4.0% (IQR: 3.0% -8.0%), 3.0% (IQR: 1.95-5.01), based on the Framingham, SCORE, WHO and D.A.D scores respectively. There was a strong positive and statistically significant correlation between CVR scores based on the general population and scores obtained using the D.A.D algorithm: Framingham and D.A.D (r = 0.802; p??0.001); SCORE and D.A.D (r = 0.652; p??0.001); WHO and D.A.D (r = 0.577; p??0.001). The level of agreement in classifying low, moderate and high risk patients between the Framingham score and the D.A.D score was 71.2% (?§ = 0.19 CI: 0.09-0.29; p??0.001). The SCORE risk and the WHO score showed respectively an agreement level of 89.6% (?§ = 0.276 CI: 0.123-0.428; p??0.001) and 83.9% (?§ = 0.21 CI: 0.06-0.35; p ??0.001) with the D.A.D score. Conclusion: The overall CVR estimated by the different CVR estimation scores allowed us to highlight a low prevalence of PLWHIV with high CVR. The WHO clinical CVR estimation scale could be a low cost alternative to evaluate CVR in resource-limited countries such as Togo.

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Abdou Razak MOUKAILA
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