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贝宁国立教学医院接受抗逆转录病毒治疗的HIV/AIDS感染者高血压患病率及相关因素

Prevalence and associated factors of hypertension among people living with HIV/AIDS on antiretroviral therapy in Benin’s National Teaching Hospital

Nature 等信源发布 2024-07-24 12:31

可切换为仅中文


AbstractAntiretroviral therapy (ART) has extended the lifespan of people living with HIV/AIDS (PLHIV), exposing them to a higher risk of cardiovascular diseases (CVD). Hypertension (HTN), the primary contributor to CVD burden, is increasingly concerning for PLHIV. This study aimed to assess the prevalence and associated factors of hypertension in PLHIV on ART at the National Teaching Hospital Hubert Koutoukou Maga (HKM) of Benin using a prospective cross-sectional study conducted between October and December 2021.

。高血压(HTN)是导致心血管疾病负担的主要因素,越来越受到PLHIV的关注。这项研究旨在使用2021年10月至12月期间进行的前瞻性横断面研究,评估贝宁国家教学医院Hubert Koutoukou Maga(HKM)接受抗逆转录病毒治疗的艾滋病毒感染者高血压的患病率和相关因素。

Patients who had a systolic blood pressure ≥ 140 mmHg or/and diastolic blood pressure ≥ 90 mmHg or/and current use of antihypertensive medication from medical records were considered to have HTN. A total of 352 patients, including 260 women with a sex ratio of 0.3 were included. The mean age was 42.9 ± 11.9 years.

收缩压≥140 mmHg或/和舒张压≥90 mmHg或/和目前使用医疗记录中抗高血压药物的患者被认为患有HTN。共纳入352名患者,其中260名女性,性别比为0.3。平均年龄为42.9±11.9岁。

Most patients were educated and did not use tobacco. 42.0% were current alcohol drinkers. The duration of ART treatment ranged from 0 to 22 years, with a median duration of 5.0 years. 14.2% were hypertensives with 3.1% newly diagnosed and 11.1% known with hypertension. Age above 40 years, living with a partner, alcohol consumption and body mass index greater than 25 were significantly associated with HTN.

大多数患者受过教育,不吸烟。42.0%是目前的饮酒者。ART治疗的持续时间为0至22年,中位持续时间为5.0年。高血压患者占14.2%,新诊断者占3.1%,已知高血压患者占11.1%。。

HTN in PLHIV is associated with numerous factors. Reducing the burden of the disease in target people in Benin requires a wide range of actions that need to be implemented..

PLHIV中的HTN与许多因素有关。减轻贝宁目标人群的疾病负担需要采取广泛的行动。。

IntroductionCurrently, one of the predominant global health challenges lies in the escalating burden of HIV/AIDS, with a cumulative toll of 40.1 million lives worldwide. In 2021 alone, HIV-related causes led to 650,000 deaths globally, while 1.5 million individuals contracted the disease globally. Statistics provided by the World Health Organization (WHO) reveal that by the conclusion of 2021, approximately 38.4 million individuals were living with HIV, with the WHO African region harboring two-thirds of this population, estimated at 25.6 million1.

引言目前,全球健康面临的主要挑战之一在于艾滋病毒/艾滋病的负担不断增加,全球累计死亡人数为4010万。仅在2021年,与艾滋病毒相关的原因就导致全球65万人死亡,而全球有150万人感染了这种疾病。世界卫生组织(世卫组织)提供的统计数字显示,到2021年底,约有3840万人感染艾滋病毒,世卫组织非洲地区拥有三分之二的艾滋病毒感染者,估计为2560万人1。

In Benin, despite a declining trend in HIV incidence from 2.2 in 1995 to 0.2 in 2021, approximately 1.2% of adults were HIV positive, translating to an estimated 69,000 People Living with HIV (PLHIV) in the country as per ONUSIDA2,3. In the past decade, notable advancements have been made in the management of HIV/AIDS due to the proliferation of various antiretroviral therapies (ART).

在贝宁,尽管艾滋病毒发病率从1995年的2.2下降到2021年的0.2,但大约1.2%的成年人艾滋病毒呈阳性,根据ONUSIDA2,3,该国估计有69000人感染艾滋病毒(PLHIV)。在过去十年中,由于各种抗逆转录病毒疗法(ART)的扩散,艾滋病毒/艾滋病的管理取得了显着进展。

In 2014, the Joint United Nations Program on HIV/AIDS (UNAIDS) introduced the 90–90-90 targets, aimed at achieving 90% awareness of HIV status among all individuals, ensuring that 90% of diagnosed HIV cases receive continuous ART, and attaining viral suppression in 90% of those receiving ART4. These initiatives have led to a decline in HIV/AIDS-related mortality rates.

2014年,联合国艾滋病毒/艾滋病联合规划署(UNAIDS)推出了90-90-90目标,旨在使所有人对艾滋病毒状况的认识达到90%,确保90%的确诊艾滋病毒病例接受持续的抗逆转录病毒治疗,并在90%的接受抗逆转录病毒治疗的患者中实现病毒抑制4。这些举措导致艾滋病毒/艾滋病相关死亡率下降。

For instance, in Benin, the proportion of PLHIV receiving ART surged from 41 to 84% between 2014 and 2021, as reported by The National Health Program against HIV/AIDS. Conversely, the annual count of HIV/AIDS-related deaths has decreased from 2400 to 1600 during the same period3,5.Additionally, cardiovascular diseases (CVD) represent a prominent global health concern and stand as the foremost cause of mortality worldwide6,7.

例如,根据国家艾滋病毒/艾滋病健康计划的报告,在贝宁,2014年至2021年间,接受抗逆转录病毒治疗的艾滋病毒感染者比例从41%飙升至84%。相反,同期艾滋病毒/艾滋病相关死亡人数从2400人下降到1600人3,5。此外,心血管疾病(CVD)是一个突出的全球健康问题,是全球死亡的首要原因6,7。

Hypertension (HTN), described as an elevated and persist.

高血压(HTN),被描述为升高并持续存在。

Figure 1Consort diagram of included patients in our study, National Teaching Hospital of Benin, 2021.Full size imageTable 1 General characteristics of PLHIV on ART in National Teaching Hospital of Benin, 2021.Full size tableAdditionally, the findings of our study reveal a notable prevalence of health-conscious behaviors among the participants.

图1我们研究中纳入患者的分类图,贝宁国家教学医院,2021年。全尺寸图像表1贝宁国家教学医院2021年抗逆转录病毒感染艾滋病毒的一般特征。全尺寸表此外,我们的研究结果显示参与者中健康意识行为的显着流行。

Specifically, a substantial proportion, comprising 96.0% of the patient cohort, reported never having used tobacco, while approximately half (48.3%) disclosed a history of abstaining from alcohol consumption. Moreover, a mere 0.3% acknowledged indulging in excessive salt intake, while a modest 2.3% claimed regular consumption of fruits and vegetables.

具体而言,相当一部分(占患者队列的96.0%)报告从未使用过烟草,而大约一半(48.3%)披露了戒酒史。此外,只有0.3%的人承认摄入过量的盐,而只有2.3%的人声称经常食用水果和蔬菜。

Additionally, an encouraging trend was observed regarding physical activity, with nearly three-quarters of the subjects reporting adherence to regular exercise routines.Furthermore, all individuals enrolled in our study were confirmed to be HIV positive and were receiving non-nucleoside reverse transcriptase inhibitor (NNRTI)-class antiretroviral therapy (ART).

此外,在体育锻炼方面观察到了令人鼓舞的趋势,近四分之三的受试者报告坚持定期锻炼。此外,所有参加我们研究的个体均被证实为HIV阳性,并正在接受非核苷逆转录酶抑制剂(NNRTI)类抗逆转录病毒治疗(ART)。

The results indicated that 10.5% of participants met the criteria for clinical failure, while 6.0% were classified as experiencing immunological failure. Furthermore, approximately 43.5% of the study cohort exhibited a normal body mass index (BMI), whereas only 3.1% were classified as overweight. These findings suggest a concerning proportion of participants with abnormal Body Mass Index.Prevalence of hypertensionTable 2 describe the distribution of hypertension prevalence among HIV patients on ART in our study sample.

结果表明,10.5%的参与者符合临床失败的标准,而6.0%的参与者被归类为经历免疫失败。此外,大约43.5%的研究队列表现出正常的体重指数(BMI),而只有3.1%被归类为超重。这些发现表明,体重指数异常的参与者比例令人担忧。高血压患病率表2描述了在我们的研究样本中,接受ART治疗的HIV患者中高血压患病率的分布。

Among these patients, 14.2% had hypertension. The frequency of those who were known to be hypertensive was 11.1% and 3.1% were screened during the study. Amongst those who had a history of HTN, 93.7% had a norma.

在这些患者中,有14.2%患有高血压。已知高血压患者的频率为11.1%,研究期间筛查了3.1%。在有HTN病史的人中,93.7%的人有正常值。

Table 2 Distribution of HTN in PLHIV in National Teaching Hospital of Benin, 2021.Full size tableFactors associated with hypertension among PLHIV on ARTThe univariable analysis identified age as the sole sociodemographic factor significantly associated with hypertension, with older individuals exhibiting a higher risk.

表2 2021年贝宁国家教学医院PLHIV中HTN的分布。ART中PLHIV中与高血压相关的全尺寸表因素单变量分析确定年龄是与高血压显着相关的唯一社会人口因素,老年人表现出更高的风险。

Notably, alcohol consumption (p = 0.0082), and the duration of ART (p = 0.0088) also showed significant associations with hypertension, while no significant association was observed between the type of treatment and hypertension. Moreover, higher BMI was significantly associated with hypertension (p = 0.0001).

值得注意的是,饮酒(p=0.0082)和ART持续时间(p=0.0088)也与高血压显着相关,而治疗类型与高血压之间没有显着相关性。此外,较高的BMI与高血压显着相关(p=0.0001)。

Subsequent multivariable analysis, conducted through stepwise descending logistic regression, revealed that age (p < 0.0001), marital status (p = 0.0313), alcohol consumption (p = 0.0037), and body mass index (p = 0.0012) were the variables demonstrating association with hypertension (Table 3). Regarding the direction of association, individuals aged over 40 (aOR: 6.5; 95% CI: 2.8–17.8), those who consumed alcohol (aOR: 2.8; CI: 1.4–5.6), and those with a BMI over 25 (aOR: 2.9; CI = 2.9; 1.5—5.6) exhibited an increased risk of hypertension.

随后通过逐步下降逻辑回归进行的多变量分析显示,年龄(p<0.0001),婚姻状况(p=0.0313),饮酒量(p=0.0037)和体重指数(p=0.0012)是与高血压相关的变量(表3)。关于关联方向,40岁以上的个体(aOR:6.5;95%CI:2.8-17.8),饮酒的个体(aOR:2.8;CI:1.4-5.6)和BMI超过25的个体(aOR:2.9;CI=2.9;1.5-5.6)表现出高血压风险增加。

Conversely, individuals living with a partner (aOR: 0.5; CI: 0.2–0.9) demonstrated a reduced risk of developing hypertension (Fig. 2)..

相反,与伴侣一起生活的人(aOR:0.5;CI:0.2-0.9)表现出患高血压的风险降低(图2)。。

Table 3 Analysis of factors associated with HTN in PLHIV in National Teaching Hospital of Benin, 2021.Full size tableFigure 2Factors associated with HTN in PLHIV in National Teaching Hospital of Benin, 2021.Full size imageDiscussionThe objective of this investigation was to ascertain the determinants linked to hypertension among PLHIV receiving ART at the National Teaching Hospital HKM of Benin.

表3 2021年贝宁国家教学医院PLHIV中与HTN相关的因素分析。全尺寸表图2 2021年贝宁国家教学医院PLHIV中与HTN相关的因素。全尺寸图像讨论本次调查的目的是确定贝宁国家教学医院HKM接受抗逆转录病毒治疗的PLHIV患者中与高血压相关的决定因素。

The observed prevalence of hypertension in this cohort stood at 14.2%, comprising 11.1% with a documented history of hypertension and 3.1% newly diagnosed cases. The average age of participants was 42.9 ± 11.9 years, with a majority being females (73.9%). A significant proportion reported never smoking, while approximately half disclosed no prior alcohol consumption.

该队列中观察到的高血压患病率为14.2%,其中11.1%有高血压病史,3.1%为新诊断病例。参与者的平均年龄为42.9±11.9岁,其中大多数为女性(73.9%)。很大一部分人表示从未吸烟,而大约一半人表示以前没有饮酒。

Key factors associated with hypertension included advancing age, marital status, alcohol intake, and body mass index (BMI). These findings reveal the multifactorial nature of hypertension in PLHIV on ART and emphasize the importance of targeted interventions addressing modifiable risk factors such as lifestyle habits and obesity.The prevalence of hypertension in our study population appears comparatively low, ranging from 24.7% in Rwanda to 43.9% in Denmark, as reported in previous studies13,15,17,18,19,20,21.

与高血压相关的关键因素包括年龄增长,婚姻状况,酒精摄入量和体重指数(BMI)。这些发现揭示了艾滋病毒携带者在抗逆转录病毒治疗中高血压的多因素性质,并强调了针对性干预措施的重要性,这些干预措施可以解决生活习惯和肥胖等可改变的风险因素。正如先前的研究13,15,17,18,19,20,21所报道的那样,我们研究人群的高血压患病率似乎相对较低,从卢旺达的24.7%到丹麦的43.9%。

This lower prevalence could be attributed to the relatively younger age of our cohort compared to those in other studies, as age is a well-established risk factor for hypertension, with individuals over 40 years exhibiting a higher risk. This finding aligns with similar observations in the literature15,19,21.Moreover, our study revealed a notable female predominance, with women comprising 73.9% of the population, a trend also observed in studies from Nigeria, South Africa, and Kenya19,22,23,24.

这种较低的患病率可能是由于与其他研究相比,我们队列的年龄相对较小,因为年龄是高血压的公认危险因素,40岁以上的个体表现出较高的风险。这一发现与文献[15,19,21]中的类似观察结果一致。此外,我们的研究显示女性占主导地位,女性占人口的73.9%,尼日利亚,南非和肯尼亚的研究也观察到这一趋势[19,22,23,24]。

This prevalence.

这种流行。

Data availabiltyThe data supporting the finding will be attached to the editorial office with a reasonable request at any time.

数据可用性支持这一发现的数据将在任何时候以合理的要求附在编辑部。

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Download referencesAcknowledgementsThe authors acknowledge all data collectors and respondents. They also extend their thanks to the National Teaching Hospital HKM administrators for permitting to conduct this research.FundingThe author(s) received no financial support for the research, authorship, and/or publication of this article.Author informationAuthor notesThese authors contributed equally: C.

。他们还感谢国家教学医院HKM管理人员允许进行这项研究。资助作者在本文的研究,作者和/或出版方面没有获得任何财务支持。作者信息作者注意到这些作者做出了同样的贡献:C。

O. Assogba and B. M. Ale.Authors and AffiliationsEcole Doctorale des Sciences de la Santé (EDSS), University of Abomey Calavi, Abomey Calavi, BeninCalixte Oswald Assogba, Salmane Ariyoh Amidou & Dismand Stephan HouinatoLaboratoire ses Maladies Chroniques et Neurologiques (LEMACEN), Abomey Calavi, BeninCalixte Oswald Assogba, Salmane Ariyoh Amidou & Dismand Stephan HouinatoHolo Global Health Research Institute, Cotonou, BeninBoni Maxime Ale, Eric Youm, Olushina Ayo Junior Ale & Jean Jacques NoubiapHealth Data Acumen, Cotonou, BeninBoni Maxime Ale & Olushina Ayo Junior AleInstitute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, KenyaBoni Maxime AleEcole Nationale de Formation des Techniciens Supérieurs en Santé Publique et Surveillance Epidémiologique (ENATSE), University of Parakou, Parakou, BeninYessito Corine HouehanouFaculty of Health Sciences, University of Abomey Calavi, Abomey Calavi, BeninAmen Sèminvo Sinsin & Sodjinè Jimmy Erhel AssiongbonDivision of Cardiology, Department of Medicine, University of San Francisco, San Francisco, USAJean Jacques NoubiapAuthorsCalixte Oswald AssogbaView author publicationsYou can also search for this author in.

O、 Assogba和B.M.Ale。作者和附属机构Abomey Calavi大学圣地亚哥科学博士(EDSS),Abomey Calavi,BeninCalixte Oswald Assogba,Salmane Ariyoh Amidou&Dismand Stephan Houinatolatoroire ses慢性病和神经病(LEMACEN),Abomey Calavi,BeninCalixte Oswald Assogba,Salmane Ariyoh Amidou&Dismand Stephan HouinatoHolo Global Health Research Institute,科托努,BeninBoni Maxime Ale,Eric Youm,Olushina Ayo Junior Ale&Jean Jacques Noubiaphe Alth Data Acumen,科托努,BeninBoni Maxime Ale&Olushina Ayo Junior AleInstitute of Tropical and Infectious Diseases,内罗毕大学,内罗毕,KenyaBoni Maxime AleEcole National de Formation des Techniciens Supérieurs en SantéPublique et Surveillance Epidologique(ENATSE),Parakou大学,Parakou,BeninYessito Corine HouehanouFaculty of Health Sciences,Abomey Calavi,BeninAmen Sèminvo Sinsin&SodjinèJimmy Erhel Assiongbondivion of Cardiology,医学系,(笑声),。

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PubMed Google ScholarContributionsConceptualization was led by B.M.A., C.O.A., and C.Y.H. Field data collection was conducted by C.O.A., S.A.S., and J.A. Database design and management were overseen by E.Y. Data curation responsibilities were shared among B.M.A., C.O.A., and E.Y.

PubMed谷歌学术贡献概念化由B.M.A.、C.O.A.和C.Y.H.领导。现场数据收集由C.O.A.、S.A.S.和J.A.进行。数据库设计和管理由E.Y.监督。数据管理责任由B.M.A.、C.O.A.和E.Y.分担。

Formal analysis was performed by B.M.A., C.O.A., and O.A.J.A. Methodology development involved contributions from B.M.A., C.O.A., and C.Y.H. Supervision was provided by B.M.A., D.S.H., C.Y.H., S.A., and J.N. Visualization tasks were handled by C.O.A. The original draft of the writing was prepared by C.O.A.

正式分析由B.M.A.、C.O.A.和O.A.J.A.进行。方法论开发涉及B.M.A.、C.O.A.和C.Y.H.的贡献。监督由B.M.A.、D.S.H.、C.Y.H.、S.A.和J.N.提供。可视化任务由C.O.A.处理。原稿由C.O.A.编写。

and B.M.A. Writing review and editing involved B.M.A., C.O.A., O.A.J.A., C.Y.H., E.Y., S.A., J.N., C.O.A., S.A.S., and D.S.H. It is not applicable because the manuscript cannot contain a person’s data in any form (including an individual’s detailed images or Videos).Corresponding authorCorrespondence to.

和B.M.A.写作审查和编辑涉及B.M.A.,C.O.A.,O.A.J.A.,C.Y.H.,E.Y.,S.A.,J.N.,C.O.A.,S.A.S。它不适用,因为手稿不能包含任何形式的个人数据(包括个人的详细图像或视频)。。

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Reprints and permissionsAbout this articleCite this articleAssogba, C., Ale, B., Youm, E. et al. Prevalence and associated factors of hypertension among people living with HIV/AIDS on antiretroviral therapy in Benin’s National Teaching Hospital.

转载和许可本文引用本文Assogba,C.,Ale,B.,Youm,E。等人在贝宁国家教学医院接受抗逆转录病毒治疗的艾滋病毒/艾滋病患者中高血压的患病率和相关因素。

Sci Rep 14, 17035 (2024). https://doi.org/10.1038/s41598-024-64212-3Download citationReceived: 25 February 2024Accepted: 06 June 2024Published: 24 July 2024DOI: https://doi.org/10.1038/s41598-024-64212-3Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

科学报告1417035(2024)。https://doi.org/10.1038/s41598-024-64212-3Download引文接收日期:2024年2月25日接受日期:2024年6月6日发布日期:2024年7月24日OI:https://doi.org/10.1038/s41598-024-64212-3Share本文与您共享以下链接的任何人都可以阅读此内容:获取可共享链接对不起,本文目前没有可共享的链接。复制到剪贴板。

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KeywordsPrevalenceHypertensionPeople living with HIVBenin

关键词评估高血压感染艾滋病毒的人

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