Risk Factors in Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome Patients Undergoing Antiretroviral Therapy in the State of Pernambuco, Brazil: A Case–Control Study

Gelenske, Thais; Farias, Francisco Alfredo Bandeira e; Ximenes, Ricardo Arraes de Alencar; Melo, Heloísa Ramos Lacerda de; Albuquerque, Maria de Fátima Pessoa Militão de; Carvalho, Érico Higino de; Barros, Zoraya de Medeiros; Diniz, George Tadeu Nunes; Filho, Demócrito de Barros Miranda

doi:10.1089/met.2009.0065

Cited by 12 publications

(6 citation statements)

References 29 publications

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“…LD was present in 53% of individuals using ARV therapy, in agreement with previous studies (36,37). We did not observe an association between LD and arterial stiffness, as also reported by others (29,31).…”

Section: Discussionsupporting

confidence: 92%

Is arterial stiffness in HIV-infected individuals associated with HIV-related factors?

Monteiro

Miranda-Filho

Bandeira

et al. 2012

Braz J Med Biol Res

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We investigated the association between pulse wave velocity (PWV) and HIV infection, antiretroviral treatment-related characteristics, viral load, immune status, and metabolic changes in a cross-sectional study nested in a cohort of HIV/AIDS patients who have been followed for metabolic and cardiovascular changes since 2007. The study included patients recruited from the cohort (N = 261) and a comparison group (N = 82) of uninfected individuals, all enrolled from April to November 2009. Aortic stiffness was estimated using the carotid-femoral PWV (Complior-Artech, Paris, France). The groups were similar with respect to age, metabolic syndrome, diabetes mellitus, Framingham score, and use of antihypertensive and hypolipidemic medications. Hypertension was more frequent among the controls. Individuals with HIV had higher triglyceride, glucose and HDL cholesterol levels. Among individuals with HIV/AIDS, those with a nadir CD4+ T-cell count <200 cells/mm3 had a higher PWV (P = 0.01). There was no statistically significant difference when subjects were stratified by gender. Heart rate, age, male gender, and blood pressure were independently correlated with PWV. Nadir CD4+ T-cell count did not remain in the final model. There was no significance difference in PWV between HIV-infected individuals and uninfected controls. PWV was correlated with age, gender, and blood pressure across the entire population and among those infected with HIV. We recommend cohort studies to further explore the association between inflammation related to HIV infection and/or immune reconstitution and antiretroviral use and PWV.

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Section: Discussionsupporting

confidence: 92%

Is arterial stiffness in HIV-infected individuals associated with HIV-related factors?

Monteiro

Miranda-Filho

Bandeira

et al. 2012

Braz J Med Biol Res

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“…Sex differences have been observed in the presentation of distinct metabolic risk profiles. For example, in a prospective study of 332 HIV-infected adults in Brazil, BMI was higher in HIV-infected women with lipodystrophy ( p =0.001) but lower in HIV-infected men with lipodystrophy ( p =0.04) [ 37 ]. In contrast, HIV-infected men with lipodystrophy had lower HDL, compared to women [ 37 ].…”

Section: Literature Reviewmentioning

confidence: 99%

HIV/AIDS and lipodystrophy: Implications for clinical management in resource‐limited settings

Finkelstein

Gala

Rochford

et al. 2015

Journal of the International AIDS Society

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IntroductionLipodystrophy is a term used to describe a metabolic complication of fat loss, fat gain, or a combination of fat loss and gain, which is associated with some antiretroviral (ARV) therapies given to HIV-infected individuals. There is limited research on lipodystrophy in low- and middle-income countries, despite accounting for more than 95% of the burden of HIV/AIDS. The objective of this review was to evaluate the prevalence, pathogenesis and prognosis of HIV-related lipoatrophy, lipohypertrophy and mixed syndrome, to inform clinical management in resource-limited settings.MethodsWe conducted a structured literature search using MEDLINE electronic databases. Relevant MeSH terms were used to identify published human studies on HIV and lipoatrophy, lipohypertrophy, or mixed syndrome in low-, low-middle- and upper-middle-income countries through 31 March 2014. The search resulted in 5296 articles; after 1599 studies were excluded (958 reviews, 641 non-human), 3697 studies were extracted for further review. After excluding studies conducted in high-income settings (n=2808), and studies that did not meet inclusion criteria (n=799), 90 studies were included in this review.Results and DiscussionOf the 90 studies included in this review, only six were from low-income countries and eight were from lower middle-income economies. These studies focused on lipodystrophy prevalence, risk factors and side effects of antiretroviral therapy (ART). In most studies, lipodystrophy developed after the first six months of therapy, particularly with the use of stavudine. Lipodystrophy is associated with increased risk of cardiometabolic complications. This is disconcerting and anticipated to increase, given the rapid scale-up of ART worldwide, the increasing number and lifespan of HIV-infected patients on long-term therapy, and the emergence of obesity and non-communicable diseases in settings with extensive HIV burden.ConclusionsLipodystrophy is common in resource-limited settings, and has considerable implications for risk of metabolic diseases, quality of life and adherence. Comprehensive evidence-based interventions are urgently needed to reduce the burden of HIV and lipodystrophy, and inform clinical management in resource-limited settings.

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“…Lipodystrophy was defined by self-reporting, using an appropriate diagnostic questionnaire. 32 For physical activity, the International Physical Activity Questionnaire (IPAQ) model was used 33 and for alcohol consumption, the daily intake was quantified over the last 3 months by the modified World Health Organization (WHO) questionnaire. 34 Calcium intake was evaluated based on milk or dairy product consumption.…”

mentioning

confidence: 99%

Vitamin D Deficiency in HIV-Infected Women on Antiretroviral Therapy Living in the Tropics

Conrado

Miranda-Filho

Ximenes

et al. 2011

Journal of the International Association of Physicians in AIDS

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The effects of HIV/AIDS and antiretroviral drugs on vitamin D metabolism are still mostly unknown. This was a cross-sectional study to estimate the prevalence of vitamin D deficiency and identify its association with the clinical and metabolic parameters among 214 HIV-positive female patients on antiretroviral therapy (ART) in Brazil. The prevalence of vitamin D deficiency (< 30 ng/ml) was 40.65% (87/214). Hypercholesterolemia, high LDL-c, duration of use of current antiretroviral regimen, hypertriglyceridemia, body mass index, age, hypertension, time with AIDS ≥ 10 years and hyperglycemia were selected for multivariate analysis (p < 0.20). After this analysis, hypercholesterolemia and use of current antiretroviral regimen ≥ 3 years remained independently associated with vitamin D deficiency. There was an inverse statistically significant correlation between total cholesterol and serum 25(OH)D levels. High prevalence of vitamin D deficiency was found among HIV-positive women on ART and was independently associated with its prolonged use and with hypercholesterolemia.

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Risk Factors in Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome Patients Undergoing Antiretroviral Therapy in the State of Pernambuco, Brazil: A Case–Control Study

Cited by 12 publications

References 29 publications

Is arterial stiffness in HIV-infected individuals associated with HIV-related factors?

Is arterial stiffness in HIV-infected individuals associated with HIV-related factors?

HIV/AIDS and lipodystrophy: Implications for clinical management in resource‐limited settings

Vitamin D Deficiency in HIV-Infected Women on Antiretroviral Therapy Living in the Tropics

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