Subclinical cardiovascular risk among adolescents with HIV in Tanzania: the role of sleep behaviour and antiretroviral regimen on arterial stiffness.

BACKGROUND

Data on arterial stiffness among adolescents with HIV remain limited, particularly in sub-Saharan Africa, where the HIV burden is high.

OBJECTIVE

We aimed to assess arterial stiffness among adolescents with HIV, compare these measures with already published measures, and investigate factors associated with arterial stiffness.

METHODS

A cross-sectional study among adolescents with HIV aged 10-17 years was conducted. Carotid-femoral pulse wave velocity (cfPWV) was measured to assess arterial stiffness using the SphygmoCor System (AtCor Medical), defined as a cfPWV ≥  the 90th percentile. Least absolute shrinkage and selection operator (LASSO) regression, followed by multivariable linear regression, was performed to determine associated factors.

RESULTS

Among 416 adolescents with HIV in Tanzania (mean age 14 years; 53% male), 9.6% (95% CI: 7.0-13.0) had a cfPWV ≥ the 90th percentile. The mean cfPWV in this cohort (4.77 ± 0.65 m/s) was lower than the estimates reported in several cohorts of adolescents with HIV in high-income countries and comparable to that reported in some cohorts in sub-Saharan Africa. Considering age, body mass index, and blood pressure as a priori confounders in multivariable analyses, higher cfPWV was independently associated with shorter sleep duration (β -0.04 per hour; 95%CI: -0.08, 0.0; P = 0.046), prolonged sleep latency ≥ 15 min (β 0.18; 95%CI: 0.05, 0.31; P = 0.006) and current use of a protease inhibitor antiretroviral regimen (β 0.3; 95%CI: 0.00, 0.61; P = 0.049).

CONCLUSION

Early screening for arterial stiffness among adolescents with poor sleep behaviours, prior exposure to protease inhibitor-based regimens, and traditional CVD risk factors such as high BMI and blood pressure may provide an opportunity for early intervention through targeted lifestyle changes.