Association of predicted 10 years cardiovascular mortality risk with duration of HIV infection and antiretroviral therapy among HIV-infected individuals in Durban, South Africa

Background: South Africa has the largest population of human immunodefciency virus (HIV) infected patients on antiretroviral therapy (ART) realising the benefts of increased life expectancy. However, this population may be susceptible to cardiovascular disease (CVD) development, due to the chronic consequences of a lifestyle-related combination of risk factors, HIV infection and ART. We predicted a 10-year cardiovascular mortality risk in an HIV-infected population on long-term ART, based on their observed metabolic risk factor profle. Methods: We extracted data from hospital medical charts for 384 randomly selected HIV-infected patients aged ≥30 years. We defned metabolic syndrome (MetS) subcomponents using the International Diabetes Federation defnition. A validated non-laboratory-based model for predicting a 10-year CVD mortality risk was applied and categorised into fve levels, with the thresholds ranging from very low-risk (30%). Results: Among the 384 patients, with a mean (± standard deviation) age of 42.90±8.20 years, the proportion of patients that were overweight/obese was 53.3%, where 50.9% had low high-density lipoprotein (HDL) cholesterol and 21 (17.5%) had metabolic syndrome. A total of 144 patients with complete data allowed a defnitive prediction of a 10-year CVD mortality risk. 52% (95% CI 44–60) of the patients were stratifed to very low risk (<5%) compared to 8% (95% CI 4–13) that were at a very high risk (>30%) of 10-year CVD mortality. The CVD risk grows with increasing age (years), 57.82±6.27 among very high risk and 37.52±4.50; p