Prevalence, Correlates of Dyslipidaemia, and 10-year Cardiovascular Risk among HIV-Positive and Negative Adults in Rwanda: Insights from the NCOHIRWA Cohort Study

Introduction Noncommunicable diseases, primarily cardiovascular diseases (CVDs), are an emerging cause of morbidity in sub-Saharan Africa. Dyslipidaemia, a key modifiable CVD risk factor, is increasing but remains underdiagnosed and undertreated, particularly among people living with HIV (PLHIV), where HIV-related chronic inflammation, antiretroviral therapy (ART), and sociodemographic factors may contribute. This study assessed the prevalence, correlates of dyslipidaemia, and estimated 10-year CVD risk among PLHIV and HIV-negative adults in Rwanda. Methods We analysed baseline data from 1,546 adults (1,234 PLHIV and 312 HIV-negative) enrolled in the NCOHIRWA Cohort from 12 Rwandan health facilities. Data were collected via standardised World Health Organisation (STEP) questionnaires. Dyslipidaemia was defined via the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, and 10-year CVD risk was calculated via the Framingham risk score. For group comparisons, chi-square tests were used. Multivariate logistic regression identified independent predictors of dyslipidaemia, with adjusted odds ratios and 95% confidence intervals reported. Results Overall, 979 participants (61.9%) had dyslipidaemia, with comparable prevalence rates among PLHIV (744/1234; 60.29%) and HIV-negative participants (205/312; 65.06%). The HIV-negative participants had higher LDL-C levels (59 (18.9%) vs. 120 (9.7%), p < 0.0001). Independent predictors of dyslipidaemia included female sex, older age, obesity, and widowhood. PLHIV had lower odds of having elevated total cholesterol (aOR = 0.68, 0.49–0.95). On the basis of the estimated 10-year CVD risk, 3.95% of the participants had high and 21.47% had very high 10-year CVD, respectively, which was concentrated among older, widowed women with low education levels. Conclusion Dyslipidaemia and elevated CVD risk are highly prevalent among the study participants, with disparities based on HIV status, sex, and social vulnerability. Routine lipid screening and integrated HIV-CVD care, particularly for high-risk subgroups such as older women, are essential for reducing the long-term CVD burden.