An assessment of ART-related factors as predictors of non-communicable diseases among adult patients on antiretroviral therapy in tertiary hospitals in Lagos State, Nigeria

Background Globally, antiretroviral therapy (ART) has saved millions of lives, enabling people living with HIV (PLHIV) lead longer and more productive lives, though they become more susceptible to non-communicable diseases (NCDs) later in life. However, despite therapeutic effectiveness, ART regimens have long been associated with metabolic complications. This study aims to assess ART-related factors as predictors of NCDs among adult patients on antiretroviral therapy attending tertiary health facilities in Lagos. Methods A descriptive cross-sectional study was conducted among 416 adult PLHIV attending two tertiary hospitals, using a multistage sampling method. Data was obtained using a pre-tested structured questionnaire adapted from the World Health Organization (WHO) STEPS Instrument, in addition to anthropometric and biomedical measurements. Descriptive, bivariate and multivariate analyses were carried out using IBM SPSS version 27. Results The mean age group of respondents was 49.13 ± 10.18years. Majority, 70.2% (n = 292) were female, and 54.1% (n = 225) married. The prevalence of obesity, hypertension, and diabetes was 37.3% (n = 155), 52.6% (n = 219), and 7.2% (n = 30) respectively; and over 70% of the respondents had at least one NCD. ART regimen was a predictor of obesity: patients on second-line ART regimen had 58.1% lower odds of obesity, compared with those on first-line regimen (aOR = 0.419, 95% CI: 0.219–0.801, P = 0.008). Hypertension was more prevalent among the patients on first-line ART regimen (54.6%%, χ²=3.287, P = 0.070), though not statistically significant. Conclusion This study suggests that ART regimen is a predictor of obesity, as it was more prevalent among the patients on first-line regimen. Though hypertension was also more prevalent among these patients, the association was not significant. The identification of ART regimen type as a modifiable predictor of obesity among PLHIV has direct programmatic implications for the adoption of an integrated care model that addresses the dual epidemic of HIV and NCDs, especially in resource-poor countries.