Protocol for a systematic review and meta-analysis to assess the association and risk factors for hypertension in people living with HIV (PLHIV), compared with the HIV-uninfected population
Authors: Gomes Mariene G , Rossato Sinara Laurini 
Published: November 2024

ABSTRACTIntroductionThe effectiveness of antiretroviral therapy has increased life expectancy among people living with HIV (PLHIV), yet conflicting reports persist regarding the incidence of hypertension in this population. Understanding the key risk factors for hypertension in PLHIV is crucial for informing public health policy. This article presents the protocol for a systematic review and meta-analysis aimed at exploring associations and identifying risk factors for hypertension in PLHIV compared to the HIV-uninfected population. By detailing the methodological approach, this protocol ensures consistency, transparency, and rigour throughout the study’s execution.Methods and AnalysisThis protocol outlines the planned steps for conducting the systematic review and meta-analysis following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. Observational studies addressing the association and the risk factors for hypertension in PLHIV, compared to the HIV-uninfected population among participants aged ≥ 18 years will be included. The searche will be performed across Medline (PubMed), Embase, Web of Science, Global Index Medicus with no restrictions on language and year of publication. Additionally, reference lists of included articles will be reviewed. Search results will be imported into the Covidence software, where duplicates will be removed, and data screening, selection, and extraction will be performed. Methodological quality and potential biases will be assessed using the Newcastle-Ottawa scale (NOAS), Checklist for Analytical Cross-Sectional Studies from the Joana Briggs Institute (JBI), and Grading of Recommendations Assessment, Development, and Evaluation (GRADE). All stages will be completed by three reviewers independently. Data will be systematically analysed and summarised and a meta-analysis will be performed.Ethics and DisseminationThis systematic review utilises published secondary data, thus ethics committee approval is not required. The results will be disseminated by publishing them in article format in a scientific journal.Trial and Registration NumberCRD42023424225Article SummaryStrengths and Limitations of this study-This is the first protocol for a systematic review designed to summarise differences in risk factors for hypertension by comparing people living with HIV (PLHIV) to uninfected people.-To the best of our knowledge, this is the first protocol of a systematic review and meta-analysis focusing on hypertension and its risk factors in PLHIV in comparison to uninfected people that assesses the methodological quality of studies using the GRADE method;-This systematic review imposes no restriction on language or year of publication ensuring broader coverage and more representative results;-We will rigorously apply methodological procedures for systematic reviews to guarantee unbiased and accurate results;-This systematic review may face challenges in identifying all potential risk factors that differ between PLHIV and uninfected people;-The exclusion of gray literature when searching for primary studies may pose a limitation; although we assume that focusing on peer-reviewed articles will enhance the study reliability.