Prevalence and factors associated with hypertension among adults on dolutegravir based antiretroviral therapy in Mengo Hospital

Abstract

Introduction Dolutegravir (DTG) based anti-retroviral therapy (ART) regimens have been rolled out in Uganda due to their effectiveness in the management of Human immunodeficiency virus (HIV). However, reports from developed countries suggest that DTG based ART may be associated with excessive weight gain and hyperglycemia, which could pose a risk of increase in non-communicable diseases (NCDs) like hypertension (HTN). It is important to understand the predictors and burden of HTN among adults on DTG based ART. Objectives: To determine the prevalence and factors associated with HTN among adults living with HIV on DTG based ART in Mengo Hospital. Methods: We conducted a cross-sectional study on 430 systematically sampled adults attending Mengo Hospital for HIV routine care who had been on DTG based ART for more than 6 months. A pretested standard questionnaire was used to collect data on socio-demographic, behavioral and clinical factors. Blood pressure, weight, height, fasting blood glucose and lipid profile were measured. Data were entered into EPIDATA and analyzed using STATA 14. Results: Majority of the participants were male (n=301, 70.7%), median age was 42 years [IQR: 34, 50] and BMI 26.6kg/m3 [IQR: 23.0, 30.9]. The prevalence of HTN was 27.2% (95% CI: 23.2, 31.6). Elevated triglycerides (p=0.026), age 45 years & above (p<0.001), family history of HTN (p=0.066), history of cardiovascular disease (CVD) (p<0.001) and duration on DTG based ART ≥ 2 years (p=0.023) were associated with HTN. Conclusion and recommendation: In a private not for profit hospital setting, one in every four adults on DTG based ART has HTN. Emphasis on the screening of HTN among all patients on DTG based ART. Further studies to understand the HTN DTG relation.