Cardiovascular disease risk in an urban African population: a cross-sectional analysis on the role of HIV and antiretroviral treatment

Vos, Antonie; Hoeve, Klariska; Barth, Roos E.; Peper, Joyce; Moorhouse, Michelle; Crowther, Nigel J; Venter, François; Grobbee, Diederick E.; Bots, Michiel L.; Klipstein‐Grobusch, Kerstin

doi:10.1186/s12977-019-0497-7

Cited by 15 publications

(11 citation statements)

References 51 publications

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“…This analysis is a sub-analysis of a cross-sectional study that has been described in detail previously ( 16 ). In brief, the cross-sectional study included HIV-positive participants not yet on ART, on first-line and on second-line ART, as well as HIV-negative controls in the inner city of Johannesburg, South Africa, from July 2016 to November 2017.…”

Section: Methodsmentioning

confidence: 99%

Patterns of Immune Activation in HIV and Non HIV Subjects and Its Relation to Cardiovascular Disease Risk

et al. 2021

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IntroductionInsight into inflammation patterns is needed to understand the pathophysiology of HIV and related cardiovascular disease (CVD). We assessed patterns of inflammation related to HIV infection and CVD risk assessed with carotid intima media thickness (CIMT).MethodsA cross-sectional study was performed in Johannesburg, South Africa, including participants with HIV who were virally suppressed on anti-retroviral therapy (ART) as well as HIV-negative participants who were family members or friends to the HIV-positive participants. Information was collected on CVD risk factors and CIMT. Inflammation was measured with the Olink panel ‘inflammation’, allowing to simultaneously assess 92 inflammation markers. Differences in inflammation patterns between HIV-positive and HIV-negative participants were explored using a principal component analysis (PCA) and ANCOVA. The impact of differentiating immune markers, as identified by ANCOVA, on CIMT was assessed using linear regression while adjusting for classic CVD risk factors.ResultsIn total, 185 HIV-positive and 104 HIV negative participants, 63% females, median age 40.7 years (IQR 35.4 – 47.7) were included. HIV-positive individuals were older (+6 years, p <0.01) and had a higher CIMT (p <0.01). No clear patterns of inflammation were identified by use of PCA. Following ANCOVA, nine immune markers differed significantly between HIV-positive and HIV-negative participants, including PDL1. PDL1 was independently associated with CIMT, but upon stratification this effect remained for HIV-negative individuals only.ConclusionHIV positive patients on stable ART and HIV negative controls had similar immune activation patterns. CVD risk in HIV-positive participants was mediated by inflammation markers included in this study.

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Section: Methodsmentioning

confidence: 99%

Patterns of Immune Activation in HIV and Non HIV Subjects and Its Relation to Cardiovascular Disease Risk

et al. 2021

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“…139 Similar results suggesting no difference in cIMT between PLWH taking ART and uninfected comparators, have since been replicated in urban populations in South Africa. 140 On the contrary, a large meta-analysis across sub-Saharan Africa including nearly 9000 individuals from four countries (Burkina Faso, Kenya, Ghana, and South Africa), 99 showed that although traditional CVD risk factors, such as BP, LDL, and age were associated with increased cIMT, HIV serostatus was notably associated with a decreased cIMT (−8.86 μm, 95% confidence interval: −15.7, −2.0). The combined sample appeared strongly representative of older individuals in the region (median age 50 years), with nearly 85% of PLWH on ART.…”

Section: Arteriosclerosis and Pre-clinical Atherosclerosismentioning

confidence: 99%

Prevention of cardiovascular disease among people living with HIV in sub-Saharan Africa

Okello

Almasi‐Hashiani

Bloomfield

et al. 2020

Progress in Cardiovascular Diseases

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As longevity has increased for people living with HIV (PLWH) in the United States and Europe, there has been a concomitant increase in the prevalence of cardiovascular disease (CVD) risk factors and morbidity in this population. Whereas the availability of HIV antiretroviral therapy has resulted in dramatic increases in life expectancy in sub-Saharan Africa (SSA), where over two thirds of PLWH reside, if and how these trends impact the epidemiology of CVD is less clear. In this review, we describe the current state of the science on how both HIV and its treatment impact CVD risk factors and outcomes among PLWH in sub-Saharan Africa, including regional factors (unique to SSA) likely to differentiate these relationships from the global North. We then outline how current regional guidelines address CVD prevention among PLWH and which clinical and structural interventions are best poised to confront the co-epidemics of HIV and CVD in the *

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“…The methods have been described previously. 15 In line with the inclusion criteria of the randomised controlled trials (RCTs) from which the participants were selected, four different groups consisting of PLHIV but not yet or less than 8 weeks on ART (HIV+, ART–), PLHIV and on first-line tenofovir-containing ART regimens for at least 2.5 years (HIV+, ART1), and those on second-line ART for at least 6 months (HIV+, ART2) and HIV-negative controls (HIV–) were identified.…”

Section: Methodsmentioning

confidence: 99%

The influence of HIV infection and antiretroviral treatment on pulmonary function in individuals in an urban setting in sub-Saharan Africa

Berg

Shaddock

Stacey

et al. 2021

South. Afr. j. HIV med.

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Background: With the roll-out of antiretroviral treatment (ART), the life expectancy of people with HIV and, hence, morbidity from non-communicable diseases, including pulmonary diseases, have increased.Objectives: This research study aims to investigate whether HIV infection and ART use are associated with pulmonary function, given the high frequency of pulmonary infections, including tuberculosis (TB), associated with HIV.Method: Adults living with HIV (ART-naïve, on first- or second-line ART), and age and sex matched HIV-negative controls were included in a cross-sectional study in Johannesburg, South Africa. Spirometry was performed to determine lung function, measuring the forced expiratory volume in one second (FEV1), the forced vital capacity (FVC) and the FEV1/FVC ratio before (pre), and after (post), short-acting bronchodilator. The association of HIV infection and ART use with pulmonary function was analysed using linear regression models, adjusting for age, gender, body surface area (BSA), employment, education, smoking and TB.Results: Overall, 548 participants (62% women) were included with a mean age of 38 (standard deviation [s.d.] 9.5) years. No effect of HIV or ART on post-FEV1 was observed in adjusted analysis. Additional adjustment for TB resulted in a higher post-FEV1 in participants on ART compared with HIV-negative participants, whereas TB was associated with a lower FEV1. No effect of HIV and ART on post-FEV1/FVC was observed.Conclusion: HIV infection and ART use were not associated with reduced pulmonary function in this urban African population. Tuberculosis showed a mediating effect on the association between HIV, ART and pulmonary function.

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Cardiovascular disease risk in an urban African population: a cross-sectional analysis on the role of HIV and antiretroviral treatment

Cited by 15 publications

References 51 publications

Patterns of Immune Activation in HIV and Non HIV Subjects and Its Relation to Cardiovascular Disease Risk

Patterns of Immune Activation in HIV and Non HIV Subjects and Its Relation to Cardiovascular Disease Risk

Prevention of cardiovascular disease among people living with HIV in sub-Saharan Africa

The influence of HIV infection and antiretroviral treatment on pulmonary function in individuals in an urban setting in sub-Saharan Africa

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