Burden and determinants of hyperuricemia among adults living with HIV at Lira Regional Referral Hospital in Uganda : a cross-sectional study

BACKGROUND: Hyperuricemia is an emerging metabolic complication among people living with HIV in the era of antiretroviral therapy (ART), yet evidence from sub-Saharan Africa remains limited. METHODS: A cross-sectional study was conducted at the LRRH Infectious Disease Centre between December 2024 and March 2025. A total of 385 adults living with HIV were selected using systematic sampling. Data were collected on sociodemographic, clinical, behavioral, and biochemical variables through interviews, physical examination, and laboratory testing. Serum uric acid, lipid profile, creatinine, and blood pressure were measured. Hyperuricemia was defined as serum uric acid > 7.0 mg/dL in males and > 6.0 mg/dL in females. Logistic regression was used to identify associated factors. Cardiovascular risk was assessed using the Framingham Risk Score (FRS). RESULTS: The prevalence of hyperuricemia was 21.8%. Significant predictors included comorbidities (AOR=2.16, 95% CI 1.18-3.97), elevated total cholesterol (AOR=1.79, 95% CI 1.02-3.14), overweight/obesity (AOR=4.92, 95% CI 2.73-8.84), elevated systolic blood pressure (AOR=2.12, 95% CI 1.18-3.82), and cigarette smoking (AOR=4.89, 95% CI 2.59-9.23). Hyperuricemia was significantly associated with high cardiovascular risk according to FRS classification (p<0.001). CONCLUSION: Hyperuricemia is prevalent among adults living with HIV at LRRH and is strongly associated with modifiable cardiometabolic and behavioral risk factors. These findings support routine screening and integrated cardiovascular-metabolic management within HIV care services.