Little is known on the health burden of non-communicable diseases (NCD) in people living with HIV (PWH) in Rwanda. The health determinants of major cardiovascular (CVD) diseases among people living with HIV in Rwanda is the first study to prospectively assess the incidence of major cardiovascular diseases in PWH in Rwanda and to compare it to a cohort of HIV-negative controls. We here present the protocol and preliminary recruitment results of the study.
This is a multi-center prospective cohort study recruiting participants in eight Rwandan health facilities with HIV and NCD clinics. Target enrolment is 1454 PWH, of whom 120 will be newly diagnosed with HIV, and 334 HIV-negative participants aged ≥18 years and free from major CVD at baseline. Participants undergo visits at baseline and every twelve months for four years. Socio-demographic characteristics, lifestyle habits and medical history, physical measurements through face-to-face interviews, and blood samples are collected at each visit. In the sub-cohort of participants newly diagnosed with HIV, echocardiogram, electrocardiogram, measurement of carotid intima-media thickness will be performed.
The primary outcome is the incidence of overt CVD (myocardial infarction, stroke, angina, coronary revascularization). Secondary outcomes include incidence of type II diabetes, hypertension, dyslipidemia, early markers of CVD, and all-cause mortality. Descriptive statistics were used to summarize baseline socio-demographic characteristics and lifestyle habits among recruited participants.
Since March 2021, 1334 PWH (42 newly diagnosed) and 334 HIV-negative participants were enrolled in eight selected study sites. Approximately 60% of recruited participants are women, with 48% being younger than 45 years, 26% between 45-54 years, and 26% older than 55 years, it sounds better which is in line with the age structure reported among PWH in Rwanda. Almost a third of participants were overweight, 2% were obese and 60% percent of participants reported that have ever smoked.
We have shown that recruitment in this study is feasible and progressing rapidly. Preliminary results show a high prevalence of modifiable CVD risk factors and confirm that the study will better inform public health to improve the quality of life among PWH in Rwanda.