Prevalence and Correlates of Dyslipidemia in HIV-Positive Patients at Selected Public Hospitals in Addis Ababa, Ethiopia, 2025.

BACKGROUND: Dyslipidemia is a common metabolic complication among people living with HIV and a major contributor to cardiovascular morbidity and mortality. However, it remains insufficiently characterized in Ethiopia, particularly in contemporary urban ART settings. METHODS: We conducted a facility-based cross-sectional study among 398 patients selected by systematic random sampling from November 1 to December 31, 2025. Data were collected using a structured data collection tool, entered into KoboToolbox, and analyzed in SPSS Version 27. Bivariable and multivariable logistic regression analyses were used to identify factors associated with dyslipidemia. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, and p < 0.05 was considered statistically significant. RESULTS: The median age of participants was 50 years (IQR: 42-56), and 66.8% (n = 266) were female. The median duration since HIV diagnosis was 19 years (IQR: 15-20). Predominant regimens included TDF+3TC+ DTG (72.8%). The prevalence of dyslipidemia was 65.3% (95% CI: 60.5-70.1), with elevated triglycerides (37.2%), total cholesterol (34.7%), high LDL-C (34.2%), and low HDL-C (28.1%). On multivariable analysis, dyslipidemia was significantly associated with history of ART change (AOR 2.62, 95% CI: 1.13-6.04), hypertension (AOR 2.45, 95% CI: 1.28-4.69), overweight (AOR 3.56, 95% CI: 1.44-8.81), obesity (AOR 5.15, 95% CI: 1.16-22.82), and sedentary and moderate physical activity (AOR 9.46, 95% CI: 2.46-36.32 and AOR 3.80, 95% CI: 1.77-8.18, respectively). CONCLUSION: Dyslipidemia was prevalent among approximately two in three HIV-positive patients receiving long-term ART at two tertiary hospitals in Addis Ababa, Ethiopia. These findings highlight the need for routine lipid monitoring and integrated cardiovascular risk management within HIV care settings in similar urban, tertiary-care contexts.