Hypertension Among Cohort of Persons With Human Immunodeficiency Virus Initiated on a Dolutegravir-Based Antiretroviral Regimen in Ghana
Date
2024
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Open Forum Infectious Diseases
Abstract
Background. Dolutegravir (DTG), a new antiretroviral drug, is being integrated into antiretroviral regimens for people with
human immunodeficiency virus (PWH) in Ghana. There is little evidence of the effect of DTG on blood pressure (BP) levels in
sub-Saharan Africa, especially West Africa. Our aim was to assess the incidence and predictors of hypertension (HTN) among
PWH initiated on a DTG-based antiretroviral regimen in Ghana.
Methods. An observational multicenter longitudinal study was conducted among PWH in Ghana from 2020 to 2022. BPs of
nonhypertensive patients with BP ≤120/80 mm Hg at baseline were measured at 3, 6, 12, and 18 months post–DTG initiation.
The primary outcome of the study was incidence of HTN, defined as BP ≥140/90 mm Hg. Kaplan-Meier estimator was used to
estimate risk of developing HTN. Cox proportional hazards model with robust standard errors was used to estimate hazard
ratios (HRs).
Results. HTN prevalence among PWH screened was 37.3% (1366/3664). The incidence of de novo HTN among
nonhypertensive PWH at 72 weeks was 598.4 per 1000 person-years (PY) (95% confidence interval [CI], 559.2–640.3) with
incidence proportion of 59.90 (95% CI, 57.30–62.44). A quarter of those with de novo HTN developed it by month 6. Obesity
(adjusted HR [aHR], 1.27 [95% CI, 1.05–1.54]), abnormal serum urea (aHR, 1.53 [95% CI, 1.27–1.85]), and low high-density
lipoprotein (aHR, 1.45 [95% CI, 1.22–1.72]) were risk factors for HTN.
Conclusions. Incidence of HTN was high among PWH on DTG. There is a need to monitor BP for HTN in adult PWH as well
as traditional risk factors to reduce the burden of HTN and its complications.
Description
Research Article
Keywords
antiretroviral therapy, dolutegravir, HIV, hypertension, incidence