dc.contributor.author | Okello, Samson | |
dc.contributor.author | Asiimwe, Stephen B. | |
dc.contributor.author | Kanyesigye, Michael | |
dc.contributor.author | Muyindike, Winnie R. | |
dc.contributor.author | Boum, Yap | |
dc.contributor.author | Mwebesa, Bosco Bwana | |
dc.contributor.author | Haberer, Jessica E. | |
dc.contributor.author | Huang, Yong | |
dc.contributor.author | Williams, Kenneth | |
dc.contributor.author | Burdo, Tricia H | |
dc.contributor.author | Tracy, Russell P. | |
dc.contributor.author | Bangsberg, David R. | |
dc.contributor.author | Mocello, Rain | |
dc.contributor.author | Martin, Jeffrey N | |
dc.contributor.author | Hunt, Peter W. | |
dc.contributor.author | Siedner, Mark J. | |
dc.date.accessioned | 2022-01-31T13:35:24Z | |
dc.date.available | 2022-01-31T13:35:24Z | |
dc.date.issued | 2016 | |
dc.identifier.citation | Okello, S., Asiimwe, S. B., Kanyesigye, M., Muyindike, W. R., & Boum, Y. (2016). D-dimer levels and traditional risk factors are associated with incident hypertension among HIV-infected individuals initiating antiretroviral therapy in Uganda. Journal of acquired immune deficiency syndromes (1999), 73(4), 396. | en_US |
dc.identifier.uri | http://ir.must.ac.ug/xmlui/handle/123456789/1324 | |
dc.description.abstract | Objectives-We sought to describe blood pressure changes after antiretroviral therapy (ART) initiation and evaluate the association of markers of inflammation with incident hypertension in a cohort of HIV-individuals in Uganda.
Methods -We used mixed effects linear regression to model changes in systolic blood pressure (BP) over time among a cohort of HIV-infected individuals initiating ART in Uganda. After exclusion of participants with pre-existing hypertension, we identified participants with normal BP throughout follow-up (controls) and those with elevated BP on ≥3 consecutive visits (cases). Prior to ART initiation, participants had testing for lnterleukin-6, kynurenine/tryptophan ratio, lipopolysaccharide, soluble CD14, soluble CD163, and D-dimer and those with viral suppression at six months during ART had repeat tests. We fit logistic regression models to estimate associations between biomarkers and risk of incident hypertension.
Results- In the entire cohort, systolic BP increased by 9.6 mmHg/year (95% CI 7.3 - 11.8) in the first six months of ART, then plateaued. Traditional factors: male gender (AOR 2.76, 95% CI 1.34-5.68), age (AOR 1.09, 95% CI 1.04-1.13), overweight (AOR 4.48, 95%CI 1.83-10.97), and a CD4 count < 100 cells (AOR 3.08, 95% CI 1.07-8.89) were associated with incident hypertension. After adjusting for these, D-dimer levels at month 6 were inversely associated with incident hypertension (AOR 0.61, 95% CI 0.37-0.99). Although not significant, similar associations were seen with sCD14 and Kynurenine/Tryptophan (K/T) ratio.
Conclusion-Blood pressure increases early after ART initiation in Ugandans. Traditional risk factors, rather than immune activation were associated with incident hypertension in this population. | en_US |
dc.description.sponsorship | National Institute of Health (R01 MH054907, K23 MH099916, R56AI100765, R21AI078774, U01 AI069919, UM1 CA181255), Doris Duke Charitable Foundation (Clinical Scientist Development Award 2008047), the Sullivan Family Foundation, and the Canada-Africa Prevention Trials (CAPT) network. The funders had no role in study design, conduct, data analysis, or manuscript production. | en_US |
dc.language.iso | en_US | en_US |
dc.publisher | Journal of acquired immune deficiency syndromes | en_US |
dc.subject | D-dimer | en_US |
dc.subject | Immune activation | en_US |
dc.subject | Hypertension | en_US |
dc.subject | Antiretroviral therapy | en_US |
dc.subject | Africa | en_US |
dc.title | D-dimer levels and traditional risk factors are associated with incident hypertension among HIV-infected individuals initiating antiretroviral therapy in Uganda | en_US |
dc.type | Article | en_US |