Fogarty Fellow: Joseph Baluku

Joseph Baluku

Nominated From: University of Minnesota   
Research Site: Infectious Disease Institute, Makerere University  
Primary Mentor: David Meya

Research Project 

The effect of previous active tuberculosis on cardiometabolic profiles of people with HIV at an urban HIV clinic in Uganda

People living with HIV (PLHIV) are at risk of cardiovascular disease (CVD). Tuberculosis is emerging as a potential risk factor for CVD although the underlying mechanisms are not fully understood among PLHIV. Our study aim is to compare the frequency of CVD risk factors, namely, hypertension, dyslipidaemia, elevated fasting blood glucose (FBG), central obesity, and high body mass index (BMI) among PLHIV with and without previous active TB in Uganda. We will further determine the association between previous active TB and each of hypertension, dyslipidaemia, elevated FBG, central obesity, and high BMI. We shall enroll 400 PLHIV (200 with previous TB) receiving HIV care at Kiruddu National Referral Hospital, Kampala, in a cross-sectional comparative study. Participants will undergo anthropometric and blood pressure measurements. Blood samples will be tested for FBG and blood lipids. The frequency of the aforementioned CVD risk factors will be compared using Pearson’s chi-square test (or Fisher’s exact test) among PLHIV with and without previous active TB.

There is a high burden of cardiovascular disease (CVD) risk factors and CVD among marginalized racial and ethnic groups living with HIV in the US. Additionally, these groups report higher rates of TB particularly in nonUS-born individuals. It is unknown whether TB contributes to the high burden of CVD. Our study therefore will hopefully document an association between previous TB and CVD risk factors to inform the need to institute primary prevention strategies in TB survivors living with HIV. CVD risk scoring systems, which are widely used in the US, may need to incorporate previous TB in risk stratification.