Health determinants for major noncommunicable diseases among people living with HIV in Rwanda (NCOHIRWA) cohort study: rationale, protocol and baseline characteristics of participants

Background Noncommunicable diseases (NCDs) are the leading cause of death worldwide. Cardiovascular diseases (CVDs) are the top NCD killers globally as well as in Rwanda and other African countries where NCDs and infectious diseases, such as HIV, coexist. To date, the intersection of CVDs and HIV in Rwanda has not been sufficiently studied. We aimed to conduct a comprehensive analysis of CVD-related risk factors and quality of life in people living with HIV (PLHIV) and to develop a country profile on the basis of the prevalence and incidence of CVD, hypertension, and diabetes to inform future interventions. Methods We assessed the risk factors for major NCDs, including CVDs, hypertension, and diabetes among PLHIV in Rwanda in a prospective, controlled cohort study. Men and women aged 18 years and above were recruited from 12 health facilities that offer services for HIV and NCDs. Baseline characteristics and demographic data were collected at baseline via an electronic questionnaire. The follow-up physical, cardiovascular, and laboratory metrics are assessed at each visit. Results A total of 1,546 participants were recruited, comprising 1,234 (79.81%) PLHIV and 312 (20.18%) people without HIV (PWoH). The median age was 44 years (interquartile range, IQR: 17) for PLHIV and 42 years (IQR: 17) for PWoH. A total of 785 (63.6%) PLHIV and 197 (63.1%) PWoH were women. The prevalence of cardiovascular risk factors for PLHIV and PWoH were as follows: 256 (21.0%) versus 75 (24.4%) were overweight; 118 (9.7%) versus 39 (12.6%) were obese; 260 (21.1%) versus 55 (17.7%) reported having ever smoked; 219 (17.8%) versus 84 (26.9%) had a family history of hypertension; and 37 (3.0%) versus 28 (9.1%) had very high fasting blood glucose levels. Conclusion This manuscript presents the protocol and rationale of the NCOHIRWA cohort and baseline data revealing a high prevalence of modifiable NCD risk factors among PLHIV in Rwanda. Findings underscore the need to integrate NCD care into HIV services. The study supports person-centered models addressing dual disease burdens and provides a foundation for longitudinal research and policy to improve chronic disease care for PLHIV in low-resource settings.