Burden and determinants of hyperglycaemia and dyslipidaemia in Zimbabwean adults living with HIV on dolutegravir-based first-line antiretroviral therapy: A cross-sectional study
4 affiliations
- 1Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
- 2School of Pharmacy, University of the Western Cape, Cape Town, South Africa
- 3Newlands Clinic, Harare, Zimbabwe
- 4Centre for Integrated Global Biomedical Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, New York, United States of America
Abstract
Background: Dolutegravir (DTG)-based antiretroviral therapy (ART) is now the preferred first-line regimen for people living with HIV (PLWH) globally, including in Zimbabwe, which has an estimated adult HIV prevalence of 12.9%. While DTG offers a high genetic barrier to resistance and favourable tolerability, it has been linked to metabolic abnormalities — including abdominal obesity, hypertension, dyslipidaemia, and impaired glucose regulation — that cluster together and increase the risk of cardiovascular disease and type 2 diabetes. Data on this burden remain limited in Zimbabwe. We conducted an exploratory, hypothesis-generating cross-sectional study to estimate the burden of hyperglycaemia and dyslipidaemia, and to identify their correlates, among PLWH on first-line DTG-based ART. Objective: This study aimed to determine the burden and correlates of hyperglycaemia and dyslipidaemia in Zimbabwean adults living with HIV on first-line DTG-based ART. Methods: A cross-sectional study was conducted from 20 January 2025–13 February 2025. The study participants were 171 PLWH receiving first-line DTG-based treatment at Parirenyatwa Group of Hospitals, in Harare, Zimbabwe. A structured questionnaire was administered to collect demographics, lifestyle information, clinical parameters and anthropometric indices. We calculated body mass index (BMI). Blood pressure measurements were taken with the participant in a resting position. Blood samples were collected and we measured HbA1c, glucose, total cholesterol (TC), HDL cholesterol (HDL-C), LDL cholesterol (LDL-C). Results: Of the 171 participants, 67.8% were female, with a median age of 42.1 years (IQR 32.4–50.2). The majority had at least secondary education, and few were smokers (n = 9), while 23% reported alcohol use and 62.2% reported no regular exercise. Over half (57.9%) were overweight or obese, and 39.8% were hypertensive. The prevalence of dyslipidaemia and hyperglycaemia was 74.3% and 13.4%, respectively, with insulin resistance present in 56.1%. Non-ideal HDL-C was the most common lipid abnormality (50.5%), followed by raised LDL-C (33.3%), raised triglycerides (16%), and hypercholesterolaemia (10.3%). On multivariate analysis, increasing age was independently associated with hyperglycaemia (AOR 1.08, 95% CI 1.03–1.13, p = 0.002), while elevated blood pressure was independently associated with dyslipidaemia (AOR 2.64, 95% CI 1.03–6.78, p = 0.043). Conclusion: Dyslipidaemia and hyperglycaemia are highly prevalent among Zimbabwean adults on DTG-based ART, with elevated blood pressure and increasing age as key independent correlates. As this population ages on long-term ART, routine, integrated screening of BMI, blood pressure, glucose, and lipid profile is essential to mitigate cardiometabolic risk and sustain the success of DTG-based ART in Zimbabwe.
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BibTeX
@article{chirimo2026burden,
title = {{Burden and determinants of hyperglycaemia and dyslipidaemia in Zimbabwean adults living with HIV on dolutegravir-based first-line antiretroviral therapy: A cross-sectional study}},
author = {Ratidzo Chirimo and Danai Tavonga Zhou and Tinashe Mudzviti and Ian Machingura Ruredzo and Justen Manasa and Charles Chiedza Maponga and Zvenyika Alfred Reginald Gomo and Exnevia Gomo and Gene D. Morse},
journal = {PLOS One},
year = {2026},
month = oct,
doi = {10.1371/journal.pone.0359196},
url = {https://doi.org/10.1371/journal.pone.0359196},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Burden and determinants of hyperglycaemia and dyslipidaemia in Zimbabwean adults living with HIV on dolutegravir-based first-line antiretroviral therapy: A cross-sectional study
AU - Ratidzo Chirimo
AU - Danai Tavonga Zhou
AU - Tinashe Mudzviti
AU - Ian Machingura Ruredzo
AU - Justen Manasa
AU - Charles Chiedza Maponga
AU - Zvenyika Alfred Reginald Gomo
AU - Exnevia Gomo
AU - Gene D. Morse
PY - 2026
DA - 2026/10/07
JO - PLOS One
DO - 10.1371/journal.pone.0359196
UR - https://doi.org/10.1371/journal.pone.0359196
AB - Background: Dolutegravir (DTG)-based antiretroviral therapy (ART) is now the preferred first-line regimen for people living with HIV (PLWH) globally, including in Zimbabwe, which has an estimated adult HIV prevalence of 12.9%. While DTG offers a high genetic barrier to resistance and favourable tolerability, it has been linked to metabolic abnormalities — including abdominal obesity, hypertension, dyslipidaemia, and impaired glucose regulation — that cluster together and increase the risk of cardiovascular disease and type 2 diabetes. Data on this burden remain limited in Zimbabwe. We conducted an exploratory, hypothesis-generating cross-sectional study to estimate the burden of hyperglycaemia and dyslipidaemia, and to identify their correlates, among PLWH on first-line DTG-based ART. Objective: This study aimed to determine the burden and correlates of hyperglycaemia and dyslipidaemia in Zimbabwean adults living with HIV on first-line DTG-based ART. Methods: A cross-sectional study was conducted from 20 January 2025–13 February 2025. The study participants were 171 PLWH receiving first-line DTG-based treatment at Parirenyatwa Group of Hospitals, in Harare, Zimbabwe. A structured questionnaire was administered to collect demographics, lifestyle information, clinical parameters and anthropometric indices. We calculated body mass index (BMI). Blood pressure measurements were taken with the participant in a resting position. Blood samples were collected and we measured HbA1c, glucose, total cholesterol (TC), HDL cholesterol (HDL-C), LDL cholesterol (LDL-C). Results: Of the 171 participants, 67.8% were female, with a median age of 42.1 years (IQR 32.4–50.2). The majority had at least secondary education, and few were smokers (n = 9), while 23% reported alcohol use and 62.2% reported no regular exercise. Over half (57.9%) were overweight or obese, and 39.8% were hypertensive. The prevalence of dyslipidaemia and hyperglycaemia was 74.3% and 13.4%, respectively, with insulin resistance present in 56.1%. Non-ideal HDL-C was the most common lipid abnormality (50.5%), followed by raised LDL-C (33.3%), raised triglycerides (16%), and hypercholesterolaemia (10.3%). On multivariate analysis, increasing age was independently associated with hyperglycaemia (AOR 1.08, 95% CI 1.03–1.13, p = 0.002), while elevated blood pressure was independently associated with dyslipidaemia (AOR 2.64, 95% CI 1.03–6.78, p = 0.043). Conclusion: Dyslipidaemia and hyperglycaemia are highly prevalent among Zimbabwean adults on DTG-based ART, with elevated blood pressure and increasing age as key independent correlates. As this population ages on long-term ART, routine, integrated screening of BMI, blood pressure, glucose, and lipid profile is essential to mitigate cardiometabolic risk and sustain the success of DTG-based ART in Zimbabwe.
SN - 1932-6203
ER -