Cardiovascular Journal of Africa: Vol 30 No 6 (November/December 2019)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 30, No 6, November/December 2019 356 AFRICA
this is in agreement with our data, indicating an almost two-fold
increase in ART, from 46% in 2010 to 85% in 2015 in our study
cohort. However, in the total South African population, this is
not reflected, since the use of ART is estimated at 56%.22 Even
though only 46%of the HIV-infected cohort was on ART in 2010,
a marked decline in mortality rate was observed, corresponding
well with the global decline in mortality rate with ART use.2
The HIV-infected participants were younger compared to their
counterparts, and showed no difference in chronic medication
use. These factors together with the beneficial effect of ART may
have contributed to the observed decline in mortality rate.
When tracking the HIV-infected participants and their
controls over 10 years, similar changes in blood pressure and
body composition were noted, but notable differences were seen
for lipid profile and trajectory of elevated CRP, liver enzymes
and eGFR in the HIV-infected group. Contrary to expectations
of eGFR declining with age,23 the HIV-infected participants
displayed an increase in eGFR, which may suggest improved
Table 1. Characteristics of the HIV-infected and uninfected individuals successfully followed over 10 years: baseline (2005) and follow-up (2015) data
Followed up in 2015 using baseline data (2005)
p-value
10-year follow up (2015)
p-value
HIV infected
n = 117
HIV uninfected
n = 131
HIV infected
n = 117
HIV uninfected
n = 131
Sociodemographic factors
Male, n (%) 28 (23.9) 50 (38.2) 0.016 28 (23.9) 50 (38.2) 0.016
Urban, n (%) 51 (43.6) 52 (36.7) 0.53 51 (43.6) 52 (36.7) 0.53
Age, years 42.9 ± 5.64 44.7 ± 7.63 0.037 52.4 ± 5.66 54.2 ± 7.59 0.036
Anthropometry
WC, cm 74.2 (61.5; 98.0) 75.8 (62.8; 100) 0.22 81.8 (64.1; 114) 82.8 (65.3; 105) 0.57
BMI, kg/m2 22.5 (16.4; 35.6) 22.4 (16.9; 32.9) 0.85 23.2 (16.1; 37.5) 23.4 (16.1; 35.7) 0.79
Cardiovascular measurements
SBP, mmHg 122 (97.0; 155) 126 (95.0; 172) 0.11 123 (94.0; 177) 128 (99.0; 177) 0.13
DBP, mmHg 84.7 ± 13.2 85.6 ± 14.4 0.59 82.3 ± 14.3 85.4 ± 13.8 0.22
PP, mmHg 37.1 (25.0; 59.0) 40.3 (25.0; 67.0) 0.029 40.2 (24.0; 75.0) 42.6 (28.0; 73.0) 0.15
MAP, mmHg 97.5 ± 14.5 99.6 ± 16.4 0.29 97.4 ± 17.1 100 ± 16.4 0.18
HR, beats/min 76.2 ± 13.1 73.5 ± 15.5 0.14 75.3 ± 15.0 73.1 ± 13.9 0.23
Biochemical variables
TC, mmol/l 4.46 ± 1.27 5.05 ± 1.26 < 0.001 4.54 ± 1.01 4.32 ± 1.12 0.13
HDL-C, mmol/l 1.19 (0.56; 2.43) 1.58 (0.72; 3.19) < 0.001 1.29 (0.76; 2.48) 1.32 (0.77; 2.53) 0.74
LDL-C, mmol/l 2.56 ± 1.04 2.80 ± 1.12 0.085 2.56 ± 0.23 2.25 ± 1.31 0.038
TG, mmol/l 1.11 (0.52; 2.42) 1.01 (0.57; 2.46) 0.11 1.14 (0.51; 2.79) 1.01 (0.55; 2.52) 0.099
TC:HDL-C ratio 3.59 (1.84; 7.21) 3.10 (1.71; 5.88) 0.003 3.43 (1.86; 16.0) 3.01 (1.56; 6.18) 0.016
TG:HDL-C ratio 0.93 (0.30; 3.17) 0.64 (0.22; 1.79) < 0.001 0.89 (0.35; 2.39) 0.76 (0.26; 2.53) 0.11
Glucose, mmol/l 4.59 (3.30; 5.70) 4.79 (3.50; 6.30) 0.078 5.13 (4.14; 6.48) 5.09 (3.85; 7.22) 0.74
HbA1c, % 5.46 (4.80; 6.20) 5.49 (4.90; 6.20) 0.52 5.46 (4.80; 6.30) 5.70 (4.90; 6.70) 0.013
CD4 count, cells/mm3 314 (126; 702) – – 429 (145; 1035) – –
CRP, mg/l 2.31 (0.25; 40.9) 2.25 (0.23; 28.8) 0.88 4.06 (0.38; 56.9) 2.61 (0.91; 16.1) 0.022
ALT, U/l 17.5 (7.81; 46.4) 18.8 (8.00; 59.0) 0.34 20.7 (10.1; 49.3) 15.0 (8.00; 36.8) < 0.001
AST, U/l 31.5 (14.2; 96.5) 29.5 (13.4; 108) 0.41 28.2 (15.3; 88.5) 23.5 (13.5; 62.1) 0.011
GGT, U/l 48.2 (17.2; 2228) 57.5 (18.8; 442) 0.128 53.3 (13.9; 342) 36.9 (10.2; 226) 0.006
Renal function
Serum creatinine, µmol/l 69.2 (47.8; 101) 63.5 (47.0; 88.8) 0.003 55.7 (37.7; 79.8) 57.8 (37.6; 78.4) 0.42
uACR, mg/mmol 0.92 (0.15; 16.3) 0.57 (0.12; 2.63) 0.003 1.89 (0.48; 10.3) 1.48 (0.38; 9.41) 0.095
eGFR, ml/min/1.73 m2 107 (67.8; 144) 118 (85.1; 149) 0.001 118 (95.6; 139) 116 (97.9; 140) 0.64
Lifestyle factors
Tobacco use, n (%) 71 (60.7) 82 (62.6) 0.76 44/114 (38.6) 61/129 (47.3) 0.17
Alcohol use, n (%) 53 (45.3) 58 (44.3) 0.87 38/114 (33.3) 49/129 (37.9) 0.45
Medication use
ART, n (%) 0 (0) – – 77/91 (84.6)# – –
< 5 years on ART, n (%) 0 (0) – – 24/77 (31.2) – –
≥ 5 years on ART, n (%) 0 (0.0) – – 53/77 (68.8) – –
Antihypertensive, n (%) 12 (10.3) 14 (10.7) 0.91 25/112 (22.3) 39/129 (30.2) 0.17
Controlled hypertension, n (%) 2 (16.7) 1 (7.14) 0.91 11 (44.0) 15 (38.5) 0.71
Statins, n (%) 0 (0.00) 0 (0.00) 1.00 2/112 (1.79) 1/129 (0.78) 0.48
Anti-inflammatory, n (%) 15 (12.8) 22 (16.8) 0.38 7/112 (6.25) 11/129 (8.53) 0.50
Antidiabetic, n (%) 0 (0.00) 1 (0.76) 0.34 0 (0.00) 3/129 (2.33) 0.10
Mortality, n (%) 77/320 (24) 3/320 (0.09) – 0 (0.00) 0 (0.00) –
Data are arithmetic mean ± SD or geometric mean (5th and 95th percentile intervals) for logarithmically transformed variables.
Out of the 117 HIV-infected individuals, information on ART use was available for 91 participants.
SD, standard deviation; HIV, human immunodeficiency virus; n, number of participants; WC, waist circumference; BMI, body mass index; DBP, diastolic blood pres-
sure; SBP, systolic blood pressure; PP, pulse pressure, MAP, mean arterial pressure; HR, heart rate; TC, total cholesterol; LDL-C, low-density lipoprotein cholesterol;
HDL-C, high-density lipoprotein cholesterol; HbA1c, glycated haemoglobin, GGT, γ-glutamyltransferase; CRP, C-reactive protein; AST, aspartate transaminase; ALT,
alanine transaminase; uACR, urinary albumin creatinine ratio; eGFR, estimated glomerular filtration rate.