Background Coronary heart disease (CHD) and cardiovascular diseases (CVDs) events have increasing trends mainly due to the multiple and complex mechanisms of chronic inflammation and anti-retroviral drugs adverse effects during HIV course. Due to the lack of information this study aimed to analyse the CHD and CVDs risk profiles, estimate the probability of events and evaluate the accuracy of the Framingham CHD equations comprehensively in HIV-infected Malaysian subjects on highly active antiretroviral therapy (HAART).
Methods This is a cross-sectional study with a purposive sampling of 2046 HIV patients on HAART in an outpatient infectious disease clinic in Selangor Malaysia. Using digital medical records. all variables for Framingham equations including demographics, gender, fasting plasma glucose and lipid profiles, blood pressure, smoking and diabetes status, hypertension treatment, immunity indices and antiretroviral therapy were collected. 10-years CHD risks were predicted using Framingham Risk Score (FRS1998 and FRS 2002) models while CVDs risk by specific FRS (2008). Data analyses included descriptive statistics and binary logistic regression.
Results CHD risks were estimated in 1920 (FRS 1998) and 2046 (FRS 2002) of HIV subjects while CVDs risk were evaluated in 1927 subjects. Median ages and percentage of male were 44 years and 81.4% (FRS 1998, 2002 and FRS 2008). Approximatly 90% were receiving NNRTI+ NRTI and just 13% and 10% were taking tenofovir and a protease inhibitor. Beside 11% were smokers while 14% as diabetic. Dyslipidemia was seen at least in 45% of population. Equally 8% had CD4 count < 200 cells/mm3 and 9% hepatitis C. Importantly 10% and 4% had intermediate and high CHD risks (FRS 1998) and 6.6% and 3.3% with intermediate and high risks for CHD based on FRS (2002) intermediate and high risk of CVDs was prevalent in while 39% and 8% of HIV subjects. Among all studied variables, higher total cholesterol levels and older age were the strong risk predictors for CHD and CVDs (p < 0.05).
Conclusions We found a high prevalence of dyslipidemia while the CHD risks measured by the Framingham scales 1998 and 2002 were low. Notably CVDs risk was high thus further investigations as well preventive management should be prioritised in this population.