Factors associated with incidence of stroke and heart failure among people living with HIV in Ghana: Evaluating Vascular Event Risk while on Long-Term Antiretroviral Suppressive Therapy (EVERLAST) Study.

People living with HIV (PLWH) have a two-fold higher risk of cardiovascular diseases (CVDs) compared with HIV-negative populations. Although 70% of the global HIV population reside in Africa, data on CVD outcomes among PLWH are scarce. We seek to evaluate factors associated with incidence of stroke and heart failure in a prospective cohort of Ghanaian PLWH. We followed up a cohort of PLWH on antiretroviral therapy for 12 months to assess rates of clinically adjudicated stroke, and heart failure. We calculated incidence rates of events/1000 person-years and fitted Cox proportional hazards regression models to identify factors associated with incident stroke and heart failure as a combined outcome measure and as separate outcome measures. Among 255 participants, the mean age was 46 years and 211 (82.7%) were female. The participants contributed 245 years of follow-up data with mean follow-up duration of 11.5 months. There were three incident strokes giving an incidence rate of 12.24 per 1000 person-years (95% CI: 3.13-33.33) and two heart failure events with an incidence rate of 8.16 (95%CI: 1.37-26.97) per 1000 py. The combined event rate was 20.41 (95% CI: 7.48-45.24) per 1000 py. Being hypertensive was associated with aHR of 8.61 (1.32-56.04) of the combined outcome while each 100 cells/mm