Risk of coronary artery disease in individuals infected with human immunodeficiency virus

Vilela, Felippe Dantas; Lorenzo, Andréa Rocha de; Tura, Bernardo Rangel; Ferraiuoli, Giovanna Ianini; Hadlich, Marcelo; Barros, Marcelo Viana de Lima; Lima, Ana Beatriz Ribeiro; Meirelles, Vanderson

doi:10.1016/s1413-8670(11)70245-8

Cited by 13 publications

(10 citation statements)

References 37 publications

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“…The finding that PI-based ART was associated with a faster decline in TG levels, and a slower increase in TC and HDL-C levels, compared to NNRTI-based ART, was not surprising as individuals may have been switched over to lipid-friendly PIs. When the percentage change in lipid levels over time was considered, the findings that the PIs were associated with higher TG and moderately higher TC levels were consistent with results from other studies [24][25][26]. The risk of excess dyslipidaemia due to ART depended on the specific PI used, as was observed in this and other studies [27][28][29][30][31].…”

Section: Discussionsupporting

confidence: 90%

Longitudinal Analysis of the Associations between Antiretroviral Therapy, Viraemia and Immunosuppression with Lipid Levels: The D:A:D Study

Kamara¹,

Smith²,

Ryom

et al. 2015

Antiviral Therapy

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Background: Antiretroviral (ART) drugs have been associated with higher triglycerides (TG), higher total cholesterol (TC) and lower high-density lipoprotein cholesterol (HDL-C) levels. Associations between lipid levels with HIV viraemia and immunosuppression in the presence of ART remain unclear. Methods: Participants from the D:A:D study with at least one TG/TC/HDL-C measurement were included. Linear mixed effect models were used to determine the association of ART, viral load (VL), nadir and current CD4 + T-cell count and previous AIDS diagnosis with lipids. Results: Of 49,717 participants, 90%, 92% and 80% contributed at least one TG/TC/HDL-C measurement (median follow-up 6.8, 6.8 and 5.0 years, respectively). Predicted mean (95% CI) baseline levels for TG, TC and HDL-C (mmol/l), were 2.10 (2.05, 2.14), 4.94 (4.91, 4.98) and 1.08 (1.07, 1.10), respectively. Lopinavir was associated with the worst TG profile, (27.2% higher levels compared to atazanavir; 95% CI 25.2%, 29.2%), and darunavir had a similar profile as atazanavir. The nucleoside pair lamivudine/tenofovir was associated with the most favourable TG profile (-2.8%;-3.5%,-2.0%) compared with emtricitabine/tenofovir, whereas lamivudine/abacavir (+10.2%; +9.3%, +11.2%) and lamivudine/ stavudine (+8.0%; +6.9%, +9.0%), were associated with the worst. Raltegravir was associated with lower TG (-5.2%;-6.4%,-3.9%), and nevirapine had a more favourable HDL-C profile (+11.3%; +10.8%, +11.7%) than efavirenz (+5.3%; 5.0%, 5.7%), compared to atazanavir. Higher VLs were associated with lower TG/TC/HDL-C, whereas higher CD4 + T-cell counts were associated with higher TG/TC/HDL-C. Conclusions: TG, TC and HDL-C levels, which generally improved over time, are dependent on ART, viraemia and, to a lesser extent, immunosuppression.

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Section: Discussionsupporting

confidence: 90%

Longitudinal Analysis of the Associations between Antiretroviral Therapy, Viraemia and Immunosuppression with Lipid Levels: The D:A:D Study

Kamara¹,

Smith²,

Ryom

et al. 2015

Antiviral Therapy

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“…Regarding the evidence levels, the following distribution was observed: four on level IV (10,16,20,23) ; three on level V (21)(22)24) ; and ten on level VI (11)(12)(13)(14)(15)(16)(17)(18)(19)(25)(26) .…”

Section: Resultsmentioning

confidence: 97%

“…The characterization of the 17 articles showed the year of publication varied between 2001 and 2016, with six articles published in Brazil (10)(11)(12)(13)(14)(15) , five in the United States (16)(17)(18)(19)(20) , four in European countries (21)(22)(23)(24) , one article in Cameroon (25) and one in Chile (26) . Regarding the evidence levels, the following distribution was observed: four on level IV (10,16,20,23) ; three on level V (21)(22)24) ; and ten on level VI (11)(12)(13)(14)(15)(16)(17)(18)(19)(25)(26) .…”

Section: Resultsmentioning

confidence: 99%

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Systemic Arterial Hypertension in people living with HIV/AIDS: integrative review

et al. 2017

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Objective: To analyze scientific productions about the relationship between HIV and Systemic Arterial Hypertension (SAH) in people living with HIV/AIDS (PLWHA). Method: Integrative literature review in six databases, held in March 2016. “AIDS” and “hypertension” were the keywords used in Portuguese, English and Spanish languages. We found 248 articles and selected 17. The categories formulated were “prevalence of SAH in PLWHA,” “risk factors for SAH in PLWHA” and “adverse events of antiretroviral therapy (ART) that contribute to HAS.” Results: There is no consensus whether HIV and ART influence the SAH development, but there are several risk factors for SAH among PLWHA. It was observed that protease inhibitors medicines influence SAH the most. Conclusion: Guidelines for SAH prevention must be performed in all individuals, however, in PLWHA, they must focus on characteristic risk factors of this population.

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“…Although there is increasing use of nonlipid-based assessments of CVD risk, such as estimation of endothelial function (flow-mediated vasodilatation or C-IMT) and coronary artery calcification by coronary CT, which have been shown to predict CVD events in the general population, particularly Dyslipidemia, atherosclerosis & cardiovascular disease in an aging population living with HIV Review future science group in older individuals [100][101][102], their use in HIVpositive populations has largely been confined to research. However, some studies have suggested that use of C-IMT or coronary artery calcification estimation identifies subclinical atherosclerosis more accurately than the use of the more traditional risk assessments in HIV-positive subjects [103,104]. Whether their use in HIV-positive patients assessed at moderate CVD risk using conventional risk assessment may better identify those with significant atherosclerotic burden who require interventions remains to be seen.…”

Section: Assessment and Management Of Cvd Risk In Hivmentioning

confidence: 99%

Dyslipidemia, Atherosclerosis and Cardiovascular Disease: An Increasingly Important Triad in an Aging Population Living with HIV

2013

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As a result of major advances in the management of HIV over the last two decades, patients living with HIV are now encountering comorbidities commonly associated with aging. Cardiovascular disease is the leading cause of death worldwide. As the population living with HIV ages, understanding cardiovascular disease in the setting of HIV is of increasing importance. This review examines the complex interplay between cardiovascular disease, HIV infection and the drugs used to treat it, with particular emphasis on the contribution of dyslipidemia.

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Risk of coronary artery disease in individuals infected with human immunodeficiency virus

Cited by 13 publications

References 37 publications

Longitudinal Analysis of the Associations between Antiretroviral Therapy, Viraemia and Immunosuppression with Lipid Levels: The D:A:D Study

Longitudinal Analysis of the Associations between Antiretroviral Therapy, Viraemia and Immunosuppression with Lipid Levels: The D:A:D Study

Systemic Arterial Hypertension in people living with HIV/AIDS: integrative review

Dyslipidemia, Atherosclerosis and Cardiovascular Disease: An Increasingly Important Triad in an Aging Population Living with HIV

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