High dyslipidemia in people living with HIV in ghana: a cross-sectional analysis of prevalence and associated factors

Abstract

Background: Cardiovascular disease (CVD) is a leading cause of mortality among people living with HIV (PLHIV) in sub-Saharan Africa. Dyslipidemia, a major modifiable CVD risk factor, is poorly characterized in Ghanaian PLHIV, particularly across age groups. This study determined the prevalence and factors associated with dyslipidemia among PLHIV in Ghana’s Eastern Region. Methods: A facility-based cross-sectional study was conducted between February and June 2020 at two hospitals (Atua Government Hospital and St. Martins de Porres Hospital). We enrolled 440 PLHIV aged ≥ 18 years on antiretroviral therapy (ART) for ≥ 6 months, excluding pregnant/lactating individuals and those on special diets. Participants were categorized into three age groups: 18–34, 35–54, and ≥ 55 years. Dyslipidemia was defined per the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria (elevated triglycerides ≥ 150 mg/dL, LDL-C ≥ 130 mg/dL, or HDL-C < 40 mg/dL). Data on sociodemographic, lifestyle, ART history, and body composition were collected using structured questionnaires and physical measurements. Bivariate analyses and binary logistic regression identified determinants (p < 0.05). Results: The overall prevalence of dyslipidemia was 64.1% (95% CI: 59.5–68.5%). The prevalence was higher among females (64.4%) compared with males (58.2%). Regression analysis identified significant independent predictors: alcohol use (aOR = 2.05, 95% CI:1.20–3.52), physical inactivity (aOR = 1.88, 95% CI:1.12–3.15), higher BMI (aOR = 1.24 per unit increase, 95% CI:1.02–1.50), and muscle mass (aOR = 0.85 per unit increase, 95% CI:0.75–0.97). Unexpectedly, participants who reported never smoking had lower odds of dyslipidemia (aOR = 0.16, 95% CI: 0.06–0.41). No significant associations were found with ART regimen/duration, education, or age. Conclusion: Dyslipidemia is highly prevalent among Ghanaian PLHIV and is strongly associated with modifiable lifestyle and body composition factors. Integrated interventions targeting alcohol reduction, physical activity promotion, and weight management are urgently needed within routine HIV care. The unexpected association with smoking warrants further investigation.