Revista de SIDA e investigación clínica

Background: The chronic nature of HIV infection requires lifelong Antiretroviral Therapy (ART) to continuously suppress HIV viral replication, reducing morbidity and mortality. Management of co-morbidities is one of the major challenges associated with the multi-drug regimens used for HIV therapy. Hypertension as a co-morbidity in Persons Living with HIV (PLHIV) has become an important public health challenge and importantly influence patient management and service delivery at HIV clinics. This study determined the prevalence of hypertension among patients attending HIV clinic at the Korle-bu Teaching Hospital (KBTH) and also explored the nature of the relationship between HIV/ART and hypertension in order to help identify individuals who could benefit from interventions to prevent or delay the onset of complications of hypertension and thereby improve the overall quality of life of PLHIV

Methods: A simple random sampling technique was used to recruit study participants based on the routine clinic attendance sample frame. A questionnaire adapted from WHO STEPwise approach to chronic disease risk-factor surveillance was modified and used for the collection of study participants' data. The prevalence of hypertension was estimated among study participants. Socio-demographic, lifestyle, anthropometric, metabolic and HIV/ART-related factors associated with hypertension were determined by logistic regression modelling using the purposeful selection of covariates method.

Results: A total of 311 PLHIV were recruited as study participants. The present study revealed that the prevalence of hypertension in patients attending HIV clinic at KBTH was 36.7% and the factors associated with hypertension were increasing age, positive family history of hypertension, minimal exercising, current BMI ≥25.0 kg/m2, total cholesterol level ≥5.17 mmol/L, exposure to ART and increasing duration of ART exposure.

Conclusion: This study shows a high prevalence of hypertension among patients attending HIV clinic at KBTH which is associated with exposure to Antiretroviral Therapy and increasing duration of this exposure. Blood pressure monitoring should move from being routine at the HIV clinic to more purposeful screening of patients for hypertension. Patients should be encouraged to have regular blood pressure measurements at home and not only when they visit HIV clinic.

It is widely recognized that adherence to antiretroviral therapy is critical to long-term treatment success, yet rates of adherence to antiretroviral medications are frequently sub-therapeutic. The objective of this study will be to determine the factors that contribute to the nonadherence and noncompliance to antiretroviral therapy. This study will be important in that it will help identify the different factors that lead to noncompliance and the various ways these factors can be combated so as to reduce the number of people dying from HIV/AIDS related causes and also help achieve the 90-90-90 treatment plan of the WHO. The number of deaths that are recorded due to AIDS affect the country as a whole in that they are an obstacle to social economic development hence all interventions possible must be put in place to reduce the mortality of AIDS which can also be from noncompliance to Highly active anti retro viral therapy. Some of the factors associated with noncompliance to HAART have been found to be behavioural, structural, and psychosocial barriers such as depression and other mental illnesses, neurocognitive impairment, low health literacy, low levels of social support, stressful life events, high levels of alcohol consumption and active substance use, homelessness, poverty, nondisclosure of HIV serostatus to those around them, denial, stigma, and inconsistent access to medications. This proposed study will be a casecontrol study. The methodology that will be used in the study will include using data from the ART clinic at Kitwe Teaching Hospital of the patients that are on HAART.