Magnitude of Hyperuricemia and Its Associated Factors Among People Living with Human Immunodeficiency Virus Who Enrolled in First-Line Antiretroviral Therapy in Amhara Region, Ethiopia

Background: In people living with human immunodeficiency virus (PLHIV), hyperuricemia may result from antiretroviral therapy (ART)-induced metabolic changes, lifestyle behaviors, and individual host factors. However, there is a scarcity of data on the prevalence and determinants of hyperuricemia among PLHIV on ART in sub-Saharan Africa. Objective: This study aimed to assess the magnitude of hyperuricemia and its associated factors among PLHIV who enrolled in first-line ART in the Amhara Region, Ethiopia. Method: A multi-center, institution-based cross-sectional study was conducted from March 15 to June 15, 2024. Referral hospitals were selected through simple random sampling, and a total of 401 participants were enrolled from these hospitals using a systematic sampling approach. Data were collected using a structured questionnaire, patient chart review, physical measurements, and biochemical analysis. Hyperuricemia was defined as a serum uric acid level is >6 mg/dL for females and >7 mg/dL for males. Multivariable logistic regression was employed to identify the factors that are associated with hyperuricemia, and a statistical significance was decided at P  ≤ .05. Result: The overall magnitude of hyperuricemia among PLHIV was 28.2% (95% confidence interval (CI): 23.7-32.5%). Male sex (AOR = 1.79, 95% CI: 1.07, 2.98), older age (AOR = 1.03; 95% CI: 1-1.06), obesity (AOR = 2.21; 95% CI: 1.04-4.73), and longer ART duration (AOR = 1.13; 95% CI: 1.01-1.27) were significantly associated with hyperuricemia. Conclusion: Our study found a relatively high prevalence of hyperuricemia (28.2%) among PLHIV on first-line ART. Significant associated factors included male sex, older age, obesity, and longer ART duration. Therefore, early screening, particularly in males, older adults, those with obesity, and long-term ART users, is essential to prevent complications.