PhD
Proposal by Robert Rutayisire
W80/53711/2018
University
of Nairobi
ABSTRACT
Background: In sub-Saharan Africa, a home of more than 70% of people with HIV
globally, the emerging NCDs related to lifestyle risk factors raises major
concerns to developing countries that requisite to find the right balance in
resource distribution to healthcare agendas. In developed countries, the
prevention of cardiovascular diseases (CVDs) as a common NCDs in people with
HIV, to proper screen for, timely diagnose and treat and more essentially well
control its risk factors (such as insulin resistance and hyperlipidemia) have
turned out to be the priorities for
clinical care of HIV. This study will determine the impact of ART and
HIV-infection on biomarkers of CVDs among adult people with HIV.
Problem statement: In
sub-Saharan Africa, the association of ART and HIV-infection with CVDs has been
confounded by the increased prevalence and incidence of NCDs due to changes in
lifestyle. Additionally, in Rwanda, only liver and kidney function biological
assessments are routinely done during follow-up excluding any assessments for
CVD risk factors. Besides there is no clear evidence about the effect of
HIV-infection and ART on cardiovascular biomarkers. This study will provide
informed evidence about the combined effects of ART and HIV-infection with
biomarkers of CVD as risk factors to guide policies for further interventions
for prevention and treatment of CVDs among adult people with HIV.
Aim: To determine whether ART and HIV-infection are associated with
altered biomarkers of cardiovascular diseases in adult people with HIV living
in Rwanda.
Methods: A cohort study will be conducted in people with HIV, attending the
Kigali University teaching Hospital (KUTH/CHUK) HIV Clinic and Health Centers in
this catchment area for treatment and follow-up health care. Participants will
be randomly sampled. Repeated measures design will be
used; baseline and 6 months’ follow-up assessments, including an individual
interview, completion of a comprehensive health questionnaire, anthropometric
measures, biomarkers of cardiovascular diseases including lipid profile,
glycated hemoglobin, and insulin, vascular and endothelial function tests,
inflammatory and coagulation markers, where blood collection will be performed
for CVD related biomarkers assessments.Multivariate analysis of variance
(MANOVA) will allow us to test the hypothesis regarding the
effect of ART and HIV-infection on CVD related biomarkers.
Expected results: This study will provide longitudinal data about the association of
ART and HIV-infection with biomarkers of cardiovascular diseases.
Keywords: HIV-infection,
cardiovascular diseases, cardiovascular disease risk factors, highly active
antiretroviral therapy, Rwanda.
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