Prevalence and factors associated with hyperuricemia among people living with HIV in Uganda: a cross-sectional study at a tertiary hospital in Uganda

Background: Hyperuricemia is associated with an elevated risk of cardiovascular diseases (CVD) among people with HIV (PLWH). However, there is a paucity of studies examining the factors associated with hyperuricemia among PLWH in sub-Saharan Africa. Objective: This study aimed to determine the prevalence and factors associated with hyperuricemia among PLWH at a tertiary hospital in Uganda. Design: We conducted a cross-sectional study among PLWH receiving antiretroviral therapy (ART) at the HIV clinic at Kiruddu National Referral Hospital in Kampala, Uganda. Methods: Data were collected using a structured questionnaire, anthropometric and blood pressure measurements, and analysis of fasting blood glucose, blood lipids, glycated hemoglobin, and serum uric acid of blood samples from participants. Modified Poisson regression with robust standard errors was used to assess factors associated with hyperuricemia. Statistical significance was set at p < 0.05 for all analyses. Results: Among 390 PLWH, the mean (SD) age was 41.4 (12.3) years, and 209 (53.6%) were female. A total of 360 (92.3%) were on dolutegravir-based ART regimens, and 94.7% (306/323) were virally suppressed (viral load < 1000 copies/mL). The prevalence of hyperuricemia was 21.3% (83/390). Current alcohol use (adjusted prevalence ratio (aPR) = 2.07, 95% CI: 1.26, 3.41, p = 0.004) and increased respiratory rate (aPR = 1.09, 95% CI: 1.02, 1.16, p = 0.015) were independently associated with hyperuricemia. Lower oxygen saturation, duration on ART, and increased diastolic blood pressure, triglycerides, weight, BMI, and circumferences (waist, hip, neck, and mid-upper arm) were associated with hyperuricemia at bivariable analysis but lost significance after adjusting for confounders. Conclusion: One in five PLWH had hyperuricemia in this study. Alcohol use was identified as a potential modifiable risk factor for hyperuricemia. While alcohol cessation programs are needed to mitigate the risk of hyperuricemia, studies should explore the effect of hyperuricemia on lung function among PLWH.