Hypertension among people living with HIV receiving dolutegravir-based antiretroviral therapy in ethiopia: a cross-sectional study

Abstract

Recently, dolutegravir (DTG) has been associated with weight gain, dyslipidemia, and hyperglycemia, which in turn raise(s) the risk of hypertension. However, little is known about the burden of hypertension among people living with HIV (PLHIV) taking DTG-based therapy in Ethiopia. This study aimed to assess the prevalence and factors associated with hypertension among PLHIV taking DTG-based therapy. We conducted a cross-sectional study on 415 selected PLHIV aged 18 years or older who had been on DTG-based therapy for at least six months at the antiretroviral therapy (ART) clinic of Dessie Comprehensive Specialized Hospital from February 5 to April 5, 2023. Participants with a diagnosis of hypertension before DTG-based ART initiation, pregnant women, and patients who were seriously ill and unable to respond were excluded from the study. Data on sociodemographic, behavioral, and clinical characteristics were collected using a structured questionnaire and patient chart review. Blood pressure, anthropometric, and biochemical measurements were done. Hypertension was defined as systolic and/or diastolic blood pressure ≥ 140 mmHg and 90 mmHg, respectively. A multivariable logistic regression was carried out to determine factors associated with hypertension. Variables with a p-value < 0.05 were considered statistically significant. The prevalence of hypertension was 15.2% (95% CI: 11.9-19). Sex (AOR = 3.01, 95% CI: 1.56-5.79, p = 0.001), duration of taking DTG-based therapy (AOR = 3.61, 95% CI: 1.72-7.59, p = 0.001), family history of hypertension (AOR = 3.51, 95% CI: 1.54-8.04, p = 0.003), body mass index (BMI) (AOR = 1.92, 95% CI: 1.02-3.64, p = 0.044), and fasting blood glucose level (FBG) (AOR = 2.33, 95% CI: 1.01-5.39, p = 0.047) were significantly associated with hypertension among PLHIV on DTG-based ART in Ethiopia. Hypertension is not uncommon in PLHIV taking DTG-based therapy. Sex, duration of taking DTG-based therapy, family history of hypertension, BMI, and FBG levels were significant correlates of hypertension among PLHIV taking DTG-based therapy. These findings highlight the need for routine hypertension screening and lifestyle interventions for PLHIV on DTG-based therapy, particularly among males, those with prolonged use of DTG-based therapy, a family history of hypertension, elevated BMI, or increased FBG.

Keywords: ART; Dolutegravir (DTG); HIV; Hypertension; People living with HIV (PLHIV).

Fig. 1

Prevalence of hypertension among PLHIV taking DTG-based ART at DCSH.