Association of prior tuberculosis with altered cardiometabolic profiles of people with HIV: A comparative cross-sectional study in Uganda

Background: Cardiovascular disease (CVD) is the leading cause of mortality among people with HIV (PWH), but the influence of co-infections like tuberculosis (TB) on CVD risk remains underexplored. We aimed to compare cardiometabolic profiles of PWH with and without prior TB to determine if prior TB...

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Main Authors: Joseph Baruch Baluku, Diana Karungi, Brenda Namanda, Sharon Namiiro, Shamim Katusabe, Angut Mary Madalen, Martin Nabwana, Ronald Olum, Felix Bongomin, Edwin Nuwagira, Grace Kansiime, Christian Kraef, Megan Shaughnessy, Joshua Rhein, David Meya
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
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Online Access:http://www.sciencedirect.com/science/article/pii/S2405579425000142
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author Joseph Baruch Baluku
Diana Karungi
Brenda Namanda
Sharon Namiiro
Shamim Katusabe
Angut Mary Madalen
Martin Nabwana
Ronald Olum
Felix Bongomin
Edwin Nuwagira
Grace Kansiime
Christian Kraef
Megan Shaughnessy
Joshua Rhein
David Meya
author_facet Joseph Baruch Baluku
Diana Karungi
Brenda Namanda
Sharon Namiiro
Shamim Katusabe
Angut Mary Madalen
Martin Nabwana
Ronald Olum
Felix Bongomin
Edwin Nuwagira
Grace Kansiime
Christian Kraef
Megan Shaughnessy
Joshua Rhein
David Meya
author_sort Joseph Baruch Baluku
collection DOAJ
description Background: Cardiovascular disease (CVD) is the leading cause of mortality among people with HIV (PWH), but the influence of co-infections like tuberculosis (TB) on CVD risk remains underexplored. We aimed to compare cardiometabolic profiles of PWH with and without prior TB to determine if prior TB is associated with distinct cardiometabolic profiles. Methods: We conducted a comparative, cross-sectional study at a tertiary hospital in Kampala, Uganda. Participants were randomly sampled PWH aged ≥ 18 years on antiretroviral therapy. Specifically, we enrolled PWH with and without prior active TB (ratio of 1:1). Anthropometric measurements, blood pressure, fasting blood glucose (FBG), lipid profile, and glycated hemoglobin were assessed. Results: A total of 396 participants were enrolled (196 TB survivors and 200 controls). TB survivors had higher median FBG (5.5 vs. 5.1 mmol/l, p < 0.001) and a higher prevalence of DM (17.9 % vs. 9.5 %, p = 0.015). However, they had lower body mass index (23.0 vs. 25.1 kg/m2, p < 0.001) and waist circumference (81.0 vs. 84.0 cm, p = 0.026). TB survivors had higher HDL-c levels (1.0 vs. 0.8 mmol/l, p < 0.001), lower LDL-c levels (2.7 vs. 3.1 mmol/l, p < 0.001) and lower prevalence of dyslipidemia (81.7 % vs. 96.5 %, p < 0.001). Prior TB was independently associated with higher prevalence of elevated FBG (adjusted prevalence ratio (aPR) 1.79, 95 % CI 1.10–2.92) and DM (aPR 2.34, 95 % CI 1.11–4.94), but decreased risk of obesity (aPR 0.42, 95 % CI 0.20–0.88). Conclusion: TB survivors with HIV exhibit a higher risk of DM but lower risk of obesity compared to those without a history of TB, indicating a need for blood glucose monitoring among TB survivors.
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spelling doaj-art-9b923c6fcf404549a2fd59b377e415472025-08-20T02:55:07ZengElsevierJournal of Clinical Tuberculosis and Other Mycobacterial Diseases2405-57942025-05-013910052310.1016/j.jctube.2025.100523Association of prior tuberculosis with altered cardiometabolic profiles of people with HIV: A comparative cross-sectional study in UgandaJoseph Baruch Baluku0Diana Karungi1Brenda Namanda2Sharon Namiiro3Shamim Katusabe4Angut Mary Madalen5Martin Nabwana6Ronald Olum7Felix Bongomin8Edwin Nuwagira9Grace Kansiime10Christian Kraef11Megan Shaughnessy12Joshua Rhein13David Meya14Makerere University Lung Institute, Kampala, Uganda; Kiruddu National Referral Hospital, Kampala, Uganda; Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; Corresponding author at: PO Box 26343, Kampala, Uganda.Kiruddu National Referral Hospital, Kampala, UgandaMakerere University Lung Institute, Kampala, UgandaMakerere University Lung Institute, Kampala, UgandaKiruddu National Referral Hospital, Kampala, UgandaKiruddu National Referral Hospital, Kampala, UgandaMakerere University - John Hopkins University Research Collaboration, Kampala, UgandaMakerere University College of Health Sciences, Kampala, UgandaDepartment of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, UgandaDepartment of Medicine, Mbarara University of Science and Technology, Mbarara, UgandaDepartment of Medicine, Mbarara University of Science and Technology, Mbarara, UgandaDepartment of Infectious Diseases, Rigshospitalet, University of Copenhagen, DenmarkDivision of Infectious Disease, Department of Medicine, Hennepin County Medical Center, Minneapolis, USADivision of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, USAMakerere University College of Health Sciences, Kampala, UgandaBackground: Cardiovascular disease (CVD) is the leading cause of mortality among people with HIV (PWH), but the influence of co-infections like tuberculosis (TB) on CVD risk remains underexplored. We aimed to compare cardiometabolic profiles of PWH with and without prior TB to determine if prior TB is associated with distinct cardiometabolic profiles. Methods: We conducted a comparative, cross-sectional study at a tertiary hospital in Kampala, Uganda. Participants were randomly sampled PWH aged ≥ 18 years on antiretroviral therapy. Specifically, we enrolled PWH with and without prior active TB (ratio of 1:1). Anthropometric measurements, blood pressure, fasting blood glucose (FBG), lipid profile, and glycated hemoglobin were assessed. Results: A total of 396 participants were enrolled (196 TB survivors and 200 controls). TB survivors had higher median FBG (5.5 vs. 5.1 mmol/l, p < 0.001) and a higher prevalence of DM (17.9 % vs. 9.5 %, p = 0.015). However, they had lower body mass index (23.0 vs. 25.1 kg/m2, p < 0.001) and waist circumference (81.0 vs. 84.0 cm, p = 0.026). TB survivors had higher HDL-c levels (1.0 vs. 0.8 mmol/l, p < 0.001), lower LDL-c levels (2.7 vs. 3.1 mmol/l, p < 0.001) and lower prevalence of dyslipidemia (81.7 % vs. 96.5 %, p < 0.001). Prior TB was independently associated with higher prevalence of elevated FBG (adjusted prevalence ratio (aPR) 1.79, 95 % CI 1.10–2.92) and DM (aPR 2.34, 95 % CI 1.11–4.94), but decreased risk of obesity (aPR 0.42, 95 % CI 0.20–0.88). Conclusion: TB survivors with HIV exhibit a higher risk of DM but lower risk of obesity compared to those without a history of TB, indicating a need for blood glucose monitoring among TB survivors.http://www.sciencedirect.com/science/article/pii/S2405579425000142TBDiabetes mellitusHypertensionDyslipidemiaObesityHIV
spellingShingle Joseph Baruch Baluku
Diana Karungi
Brenda Namanda
Sharon Namiiro
Shamim Katusabe
Angut Mary Madalen
Martin Nabwana
Ronald Olum
Felix Bongomin
Edwin Nuwagira
Grace Kansiime
Christian Kraef
Megan Shaughnessy
Joshua Rhein
David Meya
Association of prior tuberculosis with altered cardiometabolic profiles of people with HIV: A comparative cross-sectional study in Uganda
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
TB
Diabetes mellitus
Hypertension
Dyslipidemia
Obesity
HIV
title Association of prior tuberculosis with altered cardiometabolic profiles of people with HIV: A comparative cross-sectional study in Uganda
title_full Association of prior tuberculosis with altered cardiometabolic profiles of people with HIV: A comparative cross-sectional study in Uganda
title_fullStr Association of prior tuberculosis with altered cardiometabolic profiles of people with HIV: A comparative cross-sectional study in Uganda
title_full_unstemmed Association of prior tuberculosis with altered cardiometabolic profiles of people with HIV: A comparative cross-sectional study in Uganda
title_short Association of prior tuberculosis with altered cardiometabolic profiles of people with HIV: A comparative cross-sectional study in Uganda
title_sort association of prior tuberculosis with altered cardiometabolic profiles of people with hiv a comparative cross sectional study in uganda
topic TB
Diabetes mellitus
Hypertension
Dyslipidemia
Obesity
HIV
url http://www.sciencedirect.com/science/article/pii/S2405579425000142
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