Background
Methods
Study design
Study area
Study population
Study procedure
Laboratory analysis
Definitions
Statistical analysis
Ethical issues
Results
Enrollment
Baseline characteristics
Variable | HIV-negative | HIV-infected, | HIV-infected, |
---|---|---|---|
Proportion (%) | control | ART-naive | on ART |
Median [IQR] | (number = 153) | (number = 151) | (number = 150) |
Female
| 94 (61.4%) | 89 (58.9%) | 115 (76.7%) |
Age (in years)
| 38 [32 to 46] | 37 [32 to 44] | 40 [38 to 47] |
Education level
| |||
Incomplete primary | 27 (17.7%) | 25 (16.6%) | 30 (20.0%) |
Complete primary | 82 (53.6%) | 98 (64.9%) | 94 (62.7%) |
Secondary and above | 44 (28.8%) | 28 (18.5%) | 26 (17.3%) |
Work type
| |||
Manual | 109 (71.2%) | 114 (75.5%) | 105 (70.0%) |
Office | 44 (28.8%) | 37 (24.5%) | 45 (30.0%) |
Vigorous work
| 15 (9.8%) | 21 (13.9%) | 33 (22.0%) |
Mode of transportation
| |||
Walking or bicycle | 130 (85.0%) | 110 (72.9%) | 117 (78.0%) |
Motorized vehicle | 23 (15.0%) | 41 (27.1%) | 33 (22.0%) |
Ease of Living Index
a
| |||
Low | 86 (56.2%) | 94 (62.3%) | 81 (54.0%) |
Middle | 20 (13.1%) | 24 (15.9%) | 26 (17.3%) |
Higher | 47 (30.7%) | 33 (21.9%) | 43 (28.7%) |
Ever smoking
| 6 (3.9%) | 16 (10.6%) | 10 (6.7%) |
Current smoker
| 5 (3.3%) | 4 (2.7%) | 0 |
Fruit and vegetables servings/week
| 6 [4-12] | 8 [5-12] | 9 [6 to 13] |
Sugary drinks/day
| 1 [0.5 to 2] | 1 [0.5 to 2] | 1 [1 to 2] |
Current alcohol use
| |||
None | 119 (77.8%) | 120 (79.5%) | 136 (90.7%) |
< once/week | 19 (12.4%) | 16 (10.6%) | 8 (5.3%) |
≥ once/week | 15 (9.8%) | 15 (9.9%) | 6 (4.0%) |
Body Mass Index (BMI) in kg/m
2
| 23.8 [22.3 to 25.8] | 22 [20.2 to 24.3] | 23.7 [21.5 to 27.9] |
BMI <18.5 | 5 (3.3%) | 18 (11.9%) | 4 (2.7%) |
BMI 18.5 to 25 | 104 (68.0%) | 113 (74.8%) | 80 (53.3%) |
BMI 25 to 30 | 33 (21.6%) | 9 (6.0%) | 45 (30.0%) |
BMI >30 | 11 (7.2%) | 11 (7.3%) | 21 (14.0%) |
Waist-hip ratio
| 0.84 [0.82 to 0.87] | 0.84 [0.80 to 0.89] | 0.87 [0.82 to 0.91] |
Central obesity
b
| 44 (29.1%) | 56 (37.1%) | 78 (52.0%) |
Diabetes mellitus
| 0 | 1 (0.7%) | 1 (0.7%) |
Current CD4 T-cell count in cells/μL
| NA | 215 [150 to 321] | 378 [263 to 521] |
Nadir CD4 T-cell count in cells/μL
| NA | 209 [120 to 302] | 118.5 [68 to 196] |
ART duration (months)
| NA | NA | 56 [31 to 68] |
Protease inhibitor use
| NA | NA | 18 (12.0%) |
Hypertension outcomes
Variable | HIV-negative | HIV-infected, |
P-value | HIV-infected, |
P-value |
---|---|---|---|---|---|
Proportion (%) | control | ART-naïve | versus | on ART | versus |
Median [IQR] | (number = 153) | (number = 151) | control | (number = 150) | control |
Hypertension
a
| 25 (16.3%) | 8 (5.3%) |
0.003
b
| 43 (28.7%) |
0.01
|
Systolic blood pressure
| 120 [110 to 130] | 115 [110 to 120] |
0.007
| 120 [110 to 137.5] | 0.16 |
Diastolic blood pressure
| 75 [70 to 80] | 75 [70 to 80] |
0.04
| 80 [70 to 90] | 0.11 |
Heart rate
| 73 [70 to 77] | 74 [70 to 79] | 0.35 | 74 [69.5 to 85] | 0.18 |
Hypertension grade
|
P-value for trend |
P-value for trend | |||
Normal | 66 (43.1%) | 69 (45.7%) | 49 (32.7%) | ||
Prehypertension | 62 (40.5%) | 74 (49.0%) | 0.16 | 58 (38.7%) |
0.01
|
Grade 1 hypertension | 20 (13.1%) | 7 (4.6%) | 33 (22.0%) | ||
Grade 2 hypertension | 5 (3.3%) | 1 (0.7%) | 10 (6.7%) |
Factors associated with hypertension
Variable | No hypertension | Hypertension | Odds ratio [95% CI] |
---|---|---|---|
Proportion (%) | (number = 378) | (number = 76) | |
Median [IQR] | |||
Female
| 251 (66.4%) | 47 (61.8%) | 1.10 [0.64 to 1.91] |
Age (in years)
| 38 [32 to 44] | 45 [39.5 to 52] |
1.07 [1.04 to 1.09]
|
Education level
| |||
Incomplete primary | 72 (19.1%) | 10 (13.2%) | 1 |
Complete primary | 221 (58.5%) | 53 (69.7%) | 2.09 [0.97 to 4.50] |
Secondary and above | 85 (22.5%) | 13 (82.9%) | 1.57 [0.61 to 4.02] |
Work type
| |||
Manual | 274 (72.5%) | 54 (71.1%) | 1 |
Office | 104 (27.5%) | 22 (29.0%) | 1.08 [0.62 to 1.91 |
Vigorous work
| 64 (16.9%) | 5 (6.6%) |
0.33 [0.13 to 0.88]
|
Transportation
| |||
Walking or bicycle | 301 (79.6%) | 56 (74.7%) | 1 |
Motorized vehicle | 77 (20.4%) | 20 (26.3%) | 1.32 [0.73 to 2.39] |
Ease of Living Index
| |||
Low | 219 (57.9%) | 42 (55.3%) | 1 |
Middle | 54 (14.3%) | 16 (21.1%) | 1.96 [0.99 to 3.91] |
Higher | 105 (27.8%) | 18 (23.7%) | 0.96 [0.52 to 1.79] |
Ever smoking
| 26 (6.9%) | 6 (7.9%) | 1.02 [0.37 to 2.76] |
Current smoker
| 7 (1.9%) | 2 (2.6%) | 1.41 [0.25 to 8.14] |
Fruit and vegetables servings/week
| 8 [5 to 12] | 9 [5 to 13] | 1.02 [0.98 to 1.06] |
Sugary drinks/day
| 1 [1,2] | 1 [0.5 to 2] | 1.17 [0.98 to 1.40] |
Current alcohol
| |||
None | 307 (81.2%) | 68 (89.5%) | 1 |
< once/Week | 36 (9.5%) | 7 (9.2%) | 0.77 [0.31 to 1.89] |
≥ once/Week | 35 (9.3%) | 1 (1.3%) |
0.13 [0.02 to 0.99]
|
Body Mass Index (BMI) in kg/m
2
| 22.9 [20.9 to 25.1] | 24.2 [22.3 to 28.2] |
1.09 [1.03 to 1.15]
|
BMI <18.5 | 25 (6.6%) | 2 (2.6%) | 1 |
BMI 18.5 to 25 | 255 (67.5%) | 42 (55.3%) | 1.53 [0.34 to 6.84] |
BMI 25 to 30 | 67 (17.7%) | 20 (26.3%) | 3.39 [0.73 to 15.77] |
BMI >30 | 31 (8.2%) | 12 (15.8%) | 3.40 [0.67 to 17.15] |
Waist-to-Hip Ratio
| 0.84 [0.81 to 0.89] | 0.86 [0.83 to 0.91] | 1.03 [0.98 to 1.08] for each 0.01 increase |
Central obesity
a
| 142 (37.6%) | 36 (47.4%) | 1.54 [0.90 to 2.64] |
Current CD4 T-cell
count (in cells/μL)
b
| 267.5 [180 to 385] | 453 [323 to 590] |
1.003 [1.002 to 1.005]
for each cell/μL
|
<200 | 71 (28.4%) | 6 (11.8%) | 1 |
200 to 350 | 98 (39.2%) | 10 (19.6%) | 0.88 [0.30 to 2.63] |
350 to 500 | 46 (18.4%) | 15 (29.4%) | 2.44 [0.85 to 7.01] |
>500 | 35 (14.0%) | 20 (39.2%) |
4.33 [1.51 to 12.40]
|
Model | Controls (number = 153) | HIV-infected, ART naive |
P-value versus control | HIV-infected, on ART |
P-value versus control | Likelihood ratio test (compared to unadjusted model) |
---|---|---|---|---|---|---|
(number = 151) | (number = 150) | |||||
1) Unadjusted
| 1 |
0.28 [0.12 to 0.66]
|
0.003
|
2.06 [1.18 to 3.59]
|
0.01
| 0 |
2) Adjusted for age + sex
| 1 |
0.32 [0.14 to 0.75]
|
0.009
|
2.13 [1.18 to 3.85]
|
0.01
|
21.7, 2 d.f.
|
3) Adjusted for age + sex + body mass index (BMI)
| 1 |
0.34 [0.14 to 0.79]
|
0.01
|
2.04 [1.12 to 3.67]
|
0.02
|
25.7, 3 d.f.
|
4) Adjusted for age + sex + waist-hip ratio (WHR)
| 1 |
0.31 [0.13 to 0.73]
|
0.007
|
2.04 [1.12 to 3.71]
|
0.02
|
22.2, 3 d.f.
|
5) Adjusted for age + sex + BMI + vigorous work + alcohol
| 1 |
0.35 [0.15 to 0.84]
|
0.02
|
2.19 [1.18 to 4.05]
|
0.01
|
37.7, 5 d.f.
a
|
6) Adjusted for age + sex + WHR + vigorous work + alcohol
| 1 |
0.32 [0.14 to 0.77]
|
0.01
|
2.19 [1.17 to 4.10]
|
0.01
|
35.4, 5 d.f.
|
Renal disease outcomes
Variable | HIV-negative controls | HIV-infected, ART-naive |
P-value versus control | HIV-infected, on ART |
P-value versus control |
---|---|---|---|---|---|
Proportion (%) | |||||
Median [IQR] | (number = 153) | (number = 151) | (number = 150) | ||
Kidney disease
a
| 39 (25.6%) | 52 (34.4%) | 0.09 | 62 (41.3%) |
0.004
|
Creatinine (mmol/L)
| 68.3 [55.6 to 81.1] | 70.9 [57.9 to 89] | 0.49 | 64.3 [54.7 to 81.8] | 0.69 |
eGFR
| 106.5 [78.8 to 119.3] | 104.9 [79.9 to 116.7] | 0.62 | 104.4 [82.1 to 115.6] | 0.67 |
eGFR <60 mL/min
| 20 (13.1%) | 19 (12.6%) | 0.89 | 16 (10.7%) | 0.52 |
Microalbuminuria
| 31 (20.3%) | 43 (28.5%) | 0.10 | 58 (38.7%) |
0.001
|
Among 454 Tanzanian adult study participants | |||||
---|---|---|---|---|---|
Normal | Prehypertension | Hypertension Grade 1 | Hypertension Grade 2 |
P-value for trend | |
(number = 184) | (number = 194) | (number = 60) | (number = 16) | ||
Kidney Disease
a
| 44 (23.9%) | 58 (29.9%) | 40 (66.7%) | 11 (68.8%) |
<0.001
|
Microalbuminuria
| 33 (17.9%) | 49 (25.3%) | 40 (66.7%) | 10 (62.5%) |
<0.001
|
eGFR <60
| 16 (8.7%) | 19 (9.8%) | 14 (23.3%) | 6 (37.5%) |
<0.001
|
Among 153 HIV-negative adults (controls)
| |||||
Normal
|
Prehypertension
|
Hypertension Grade 1
|
Hypertension Grade 2
|
P-value for trend
| |
(number = 66)
|
(number = 62)
|
(number = 20)
|
(number = 5)
| ||
Kidney Disease
| 8 (12.1%) | 15 (24.2%) | 13 (65.0%) | 3 (60.0%) |
<0.001
|
Microalbuminuria
| 4 (6.1%) | 12 (19.4%) | 13 (65.0%) | 2 (40.0%) |
<0.001
|
eGFR <60
| 5 (7.6%) | 6 (9.7%) | 6 (30.0%) | 3 (60.0%) |
<0.001
|
Among 151 HIV-infected, ART-naive adults
| |||||
Normal
|
Prehypertension
|
Hypertension Grade 1
|
Hypertension Grade 2
|
P
-value for trend
| |
(number = 69)
|
(number = 74)
|
(number = 7)
|
(number = 1)
| ||
Kidney Disease
| 22 (31.9%) | 24 (32.4%) | 5 (71.4%) | 1 (100%) | 0.11 |
Microalbuminuria
| 16 (23.2%) | 21 (28.4%) | 5 (71.4%) | 1 (100%) |
0.02
|
eGFR <60
| 8 (11.6%) | 9 (12.2%) | 2 (28.6%) | 0 | 0.53 |
Among 150 HIV-infected adults on ART
| |||||
Normal
|
Prehypertension
|
Hypertension Grade 1
|
Hypertension Grade 2
|
P
-value for trend
| |
(number = 49)
|
(number = 58)
|
(number = 33)
|
(number = 10)
| ||
Kidney Disease
| 14 (28.6%) | 19 (32.8%) | 22 (66.7%) | 7 (70.0%) |
<0.001
|
Microalbuminuria
| 13 (26.5%) | 16 (27.6%) | 22 (66.7%) | 7 (70.0%) |
<0.001
|
eGFR <60
| 3 (6.1%) | 4 (6.9%) | 6 (18.2%) | 3 (30.0%) |
0.01
|