Factors Associated With Hypertension In HIV/AIDS Patients Undergoing Antiretroviral Therapy

Objective With the standardized antiretroviral therapy(ART),The life expectancy of people with human immunodeficiency virus(HIV)/acquired immunodeficiency syndrome(AIDS)has increased significantly,the incidence of hypertension was high in HIV population.Therefore,this study aimed to explore the factors associated with hypertension in HIV/AIDS patients undergoing normalization ART.Methods A case-control study was conducted to collect 216 HIV/AIDS patients complicated with hypertension who were hospitalized in the Third People’s Hospital of Kunming from January 1,2017 to December 31,2021 as the case group,and gender and age(±3 years)matched HIV/AIDS patients without hypertension who were hospitalized in the same period as the control group.The general demographic data,some clinical characteristics,inflammation markers and HIV-related factors of the two groups were collected through the electronic medical record system.Conditional logistics regression was used to analyze the related factors of hypertension,receiver operating characteristic(ROC)curve was used to evaluate the predictive value of related factors for the occurrence of hypertension in HIV/AIDS patients.In addition,Spearman correlation analysis was used to analyze the correlation between inflammation markers and admission CD4 cell counts,admission CD8cell counts,admission CD4/CD8 ratio.Results1 Comparison between groups:216 patients were included in the case group and the control group,respectively.including 139 males and 77 females,with a male to female ratio of about1.8:1.0.The age of case group and control group were 51.0(46.0,59.0)years and 51.5(46.0,58.8)years,respectively.The patients in the two groups were mainly Han nationality,married,long-term residents in Kunming,and unemployed.The case group was mainly infected with HIV through intravenous drug use,while the control group was mainly infected with HIV through sexual transmission.Compared with the control group,the case group had a higher rate of family history of hypertension.2 Conditional logistics regression showed that:Smoking(OR=5.03,95%CI:1.18～21.51),body mass index(BMI)≥24kg/m~2(OR=3.55,95%CI:1.28～9.83),fasting blood glucose≥7.0mmol/L(OR=5.47,95%CI:1.21～24.77),creatinine(OR=1.01,95%CI:1.002～1.02),high-sensitivity C-reactive protein(hs CRP)(OR=3.24,95%CI:1.12～9.37),neutrophil to lymphocyte ratio(NLR)(OR=1.26,95%CI:1.03～1.56),HIV/AIDS diagnosis within 5～9years(OR=13.28,95%CI:1.59～111.00),ART duration≥10 years(OR=19.43,95%CI:1.13～334.07),CD4 cell counts≥350cells/u L upon admission(OR=5.99,95%CI:1.56～22.96),and low HIV RNA(<100 copies/m L)(OR=4.63,95%CI:1.47～14.63)were risk factors for hypertension in HIV/AIDS,and high CD4/CD8 ratio upon admission(OR=0.24,95%CI:0.07～0.82)was a protective factor in HIV/AIDS.3 Spearman correlation analysis showed that NLR was negatively correlated with admission CD4 cell counts and admission CD8 cell counts.4 ROC curve analysis showed that related factors had certain predictive value for the occurrence of hypertension in HIV/AIDS patients.Conclusions1 Smoking,BMI≥24 kg/m~2,higher fasting glucose≥7.0mmol/L,creatinine,hs CRP(increased),NLR,HIV/AIDS diagnosis within 5～9 years,ART duration of≥10 years,CD4 cell counts≥350cells/u L upon admission,HIV RNA<100 copies/m L is a risk factor for HIV/AIDS patients in hypertension,high CD4/CD8 ratio were negatively associated with hypertensive risk in HIV/AIDS.NLR was negatively correlated with CD4 cell counts,CD8 cell counts.2 By monitoring risk factors,HIV/AIDS patients with normalization ART can early warn the occurrence of hypertension and improve the quality of life of HIV/AIDS patients with hypertension.3 Alleviating inflammatory may help control or delay the occurrence of hypertension in HIV/AIDS.