Spectrum and Correlates of Dyslipidemia in People Living with HIV on Dolutegravir-Based Regimen Attending Kabutare Hospital, Southern Rwanda: A Cross-Sectional Study.

Abstract

Background: Dyslipidemia, a risk factor for cardiovascular disease (CVD), is common among people living with the human immunodeficiency virus (HIV). The interaction between HIV, dolutegravir (DTG)- based antiretroviral therapy (ART), and lifestyle factors contribute to dyslipidemia, increasing CVD risk. Rwanda has made significant progress in expanding access to ART, achieving high coverage and viral suppression rates. However, comprehensive data on dyslipidemia among people living with HIV (PLWH) in Rwanda is lacking. Therefore, this study aimed to fill this gap by examining the prevalence, types, and correlates of dyslipidemia among PLWH.

Methods: This cross-sectional study with 264 participants analyzed serum lipid profiles to estimate the prevalence of dyslipidemia and specific lipid abnormalities. Demographic and lifestyle factors were collected using a questionnaire. Differences in categorical variables between HIV-positive and HIV-negative groups were assessed using chi-square or Fisher's exact tests. Continuous variables were compared using the Wilcoxon rank-sum test. Multivariable logistic regression models, stratified by HIV status, identified factors independently associated with dyslipidemia, reported as adjusted odds ratios (aOR) and 95% confidence intervals (CI). Statistical significance was defined as p-value < 0.05.

Results: Dyslipidemia (NCEP ATP III criteria) was present in 74.2% of participants, significantly higher among PLWH (82.7%) than HIV-negative group (59.4%). Hypoalphalipoproteinemia and hyperbetalipoproteinemia were more common in PLWH (72.6% and 53.0%) vs HIV-negative (57.3% and 3.1%). Male gender reduced odds of dyslipidemia in both groups; smoking significantly increased risk among PLWH (aOR 8.8; 95% CI 1.73-44.59), while alcohol consumption was protective (aOR 0.2; 95% CI 0.07-0.55). DTG- based ART duration > 6-12 months increased odds of dyslipidemia vs ≤ 6 months (aOR 4.8; 95% CI 1.11-20.93).

Conclusion: The study found a high prevalence of dyslipidemia among PLWH on ART, linked to ART duration, age, smoking and sex, highlighting the need for regular screening, lifestyle interventions, and tailored HIV care.