ArticlePloS one2019
Effect of cardio-metabolic risk factors on all-cause mortality among HIV patients on antiretroviral therapy in Malawi: A prospective cohort study.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.
- Effectiveness and safety of darunavir and lopinavir for treating children and adolescents living with HIV: a systematic review.BMC infectious diseases · 2026Pooled it
- Prevention of cardiovascular disease among people living with HIV in sub-Saharan Africa.Progress in cardiovascular diseasesPooled it
- Determinants of cardiovascular and metabolic noncommunicable diseases among people living with HIV in Rwanda: protocol for the NCOHIRWA prospective cohort study.BMC infectious diseases · 2026Article
- The association between dolutegravir based first-line antiretroviral regimens and dyslipidemia among adults living with HIV on follow-up at health facilities in Hawassa city administration, Sidama region: a cross-sectional study.Atherosclerosis plus · 2025Article
- Change in WHO cardiovascular risk prediction over three years in PLWH on efavirenz-based ART.Southern African journal of HIV medicine · 2025Article
- The burden of non-communicable diseases among people living with HIV in Sub-Saharan Africa: a systematic review and meta-analysis.EClinicalMedicine · 2023Article
- Metabolic syndrome among people living with HIV on antiretroviral therapy in Mwanza, Tanzania.BMC endocrine disorders · 2023Article
- Prevalence of and factors associated with diabetes mellitus among people living with HIV in Vietnam.Global health & medicine · 2023Article
- Metabolic Syndrome and Combination Antiretroviral Therapy in HIV Patients in Periurban Hospital in Ghana: A Case-Control Study.AIDS research and treatment · 2023Article
- The effects of ART on the dynamics of lipid profiles in Chinese Han HIV-infected patients: comparison between NRTI/NNRTI and NRTI/INSTI.Frontiers in public health · 2023Article
- Biomarkers and Prevalence of Cardiometabolic Syndrome Among People Living With HIV/AIDS, Addis Ababa, Ethiopia: A Hospital-Based Study.Clinical medicine insights. Endocrinology and diabetes · 2022Article
- Prevalence of dyslipidaemia among HIV-infected patients receiving combination antiretroviral therapy in North Shewa, Ethiopia.PloS one · 2021Article
- Inflammatory Phenotypes Predict Changes in Arterial Stiffness Following Antiretroviral Therapy Initiation.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Cardiometabolic risk factors among patients with tuberculosis attending tuberculosis treatment centers in Nepal.BMC public health · 2020Article
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Authors and funding
10 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCardiovascular disease (CVD) risk among people living with HIV is elevated due to persistent inflammation, hypertension and diabetes comorbidity, lifestyle factors and exposure to antiretroviral therapy (ART). Data from Africa on how CVD risk affects morbidity and mortality among ART patients are lacking. We explored the effect of CVD risk factors and the Framingham Risk Score (FRS) on medium-term ART outcomes.
methodsA prospective cohort study of standardized ART outcomes (Dead, Alive on ART, stopped ART, Defaulted and Transferred out) was conducted from July 2014-December 2016 among patients on ART at a rural and an urban HIV clinic in Zomba district, Malawi. The primary outcome was Dead. Active defaulter tracing was not done and patients who transferred out and defaulted were excluded from the analysis. At enrolment, hypertension, diabetes and dyslipidemia were diagnosed, lifestyle data collected and the FRS was determined. Cox-regression analysis was used to determine independent risk factors for the outcome Dead.
resultsOf 933 patients enrolled, median age was 42 years (IQR: 35-50), 72% were female, 24% had hypertension, 4% had diabetes and 15.8% had elevated total cholesterol. The median follow up time was 2.4 years. Twenty (2.1%) patients died, 50 (5.4%) defaulted, 63 (6.8%) transferred out and 800 (85.7%) were alive on ART care (81.7% urban vs. 89.9% rural). In multivariable survival analysis, male gender (aHR = 3.28; 95%CI: 1.33-8.07, p = 0.01) and total/HDL cholesterol ratio (aHR = 5.77, 95%CI: 1.21-27.32; p = 0.03) were significantly associated with mortality. There was no significant association between mortality and hypertension, body mass index, central obesity, diabetes, FRS, physical inactivity, smoking at enrolment, ART regimen and WHO disease stage.
conclusionsMedium-term all-cause mortality among ART patients was associated with male gender and elevated total/HDL cholesterol ratio.
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