Profile and Determinants of Non-Communicable Comorbidities and Chronic Co-Infections among People Living with HIV in a Multicenter Cohort in C？te d’Ivoire from 2019 to 2026
Context: The success of antiretroviral therapy has transformed HIV infection into a long-term condition, leading to the emergence of non-communicable diseases. The aim of this study is to assess the cumulative prevalence and factors associated with chronic comorbidities among people living with HIV and receiving antiretroviral therapy in C？te d’Ivoire. Methods: A retrospective observational study with an analytical focus, involving 447 medical records of people living with HIV, followed from January 2019 to June 2026. Comorbidities were identified on the basis of clinical codes and treatment prescriptions. A multivariate logistic regression analysis was carried out to identify the factors associated with the onset of non-communicable diseases. Results: The mean age was 45.7 ± 11.6 years, with a predominance of women (64 per cent); the male-to-female sex ratio was 0.56. HIV-1 was predominant (93.3%). During the study period, 28 per cent of patients had at least one chronic comorbidity, of whom 22.2 per cent had a single comorbidity and 5.8 per cent had multiple comorbidities. Among the 447 patients included, the specific prevalences of the main comorbidities were: hypertension 10.1 per cent (45/447), tuberculosis 8.7 per cent (39/447), diabetes 4.9 per cent (22/447) and hepatitis B 3.4 per cent (15/447). Of the total of 156 conditions recorded, hypertension accounted for 28.8 per cent of events. In the bivariate analysis, age (p = 0.000119), age at HIV diagnosis (p = 0.0000362), site of follow-up (p = 0.002105) and marital status (p = 0.0001456) were independently associated with comorbidities. The adjusted multivariate model showed that only the follow-up site remained significantly associated (p = 0.002). Conclusion: People living with HIV face a double burden of disease, combining persistent infectious conditions and early-onset non-communicable diseases (hypertension, diabetes). The systematic integration of screening for non-communicable diseases into HIV diagnostic centers is a priority.
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