The cardiovascular risk management for people living with HIV in Europe

Abstract

Cardiovascular risk was common. More than half modified their cardiovascular risk, and this improved over time.

High burden of metabolic comorbidities in a citywide cohort of HIV outpatients: evolving health care needs of people aging with HIV in Washington, DC

“…The period prevalence estimates obtained for the sample of adult HIV‐infected patients in the DC Cohort are generalizable to the broader HIV‐infected outpatient population in a large urban US city. Half of HIV‐infected patients in the DC Cohort were classified as hypertensive, which represents a higher prevalence compared with the 32% of participants in the EuroSIDA study , 14% of participants in the D:A:D study , 45% of participants in the Swiss HIV Cohort Study , 32% of male patients in the VACS‐VC , 32% of female patients in the WIHS , 43% of HIV‐infected outpatients at an urban New York health centre , and 44% of male patients in the MACS with hypertension , although it also represents a marginally lower prevalence compared with the 54% of male patients and 57% of female patients in the HOPS with hypertension . Among DC Cohort patients, 12% of male patients and 16% of female patients had diabetes, which was comparable to the 12% of male patients and 19% of female patients in the HOPS , 13% of male patients in the MACS , 14% of male patients in the VACS‐VC , and 18% of female patients in the WIHS with diabetes , but higher than the 5% of participants in the EuroSIDA study , 3% in the D:A:D study , and 7% in the Swiss HIV Cohort Study with diabetes .…”

“…Half of HIV‐infected patients in the DC Cohort were classified as hypertensive, which represents a higher prevalence compared with the 32% of participants in the EuroSIDA study , 14% of participants in the D:A:D study , 45% of participants in the Swiss HIV Cohort Study , 32% of male patients in the VACS‐VC , 32% of female patients in the WIHS , 43% of HIV‐infected outpatients at an urban New York health centre , and 44% of male patients in the MACS with hypertension , although it also represents a marginally lower prevalence compared with the 54% of male patients and 57% of female patients in the HOPS with hypertension . Among DC Cohort patients, 12% of male patients and 16% of female patients had diabetes, which was comparable to the 12% of male patients and 19% of female patients in the HOPS , 13% of male patients in the MACS , 14% of male patients in the VACS‐VC , and 18% of female patients in the WIHS with diabetes , but higher than the 5% of participants in the EuroSIDA study , 3% in the D:A:D study , and 7% in the Swiss HIV Cohort Study with diabetes . More than half of male patients and more than 40% of female patients in the DC Cohort were classified as dyslipidaemic, and these prevalences are higher than the 37% of male patients and 31% of female patients at an urban New York health centre , 45% of EuroSIDA study participants , and 42% of D:A:D study participants with dyslipidaemia , but lower than the 58% of male patients in the VACS‐VC , 81% of male patients and 67% of female patients in the HOPS , and 92% of male patients in a MACS substudy with dyslipidaemia ; these large differences might be attributed to different histories of ARV therapy and/or the use of different quantitative cut‐offs for various lipid parameters to define dyslipidaemia.…”

“…Metabolic comorbidities among HIV‐infected persons have been examined in other large observational cohort studies including the EuroSIDA study , Data Collection on Adverse Events of Anti‐HIV Drugs (D:A:D) study , Swiss HIV Cohort Study , HIV Outpatient Study (HOPS) , Veterans Aging Cohort Study (VACS) and its Virtual Cohort (VACS‐VC) , Multicenter AIDS Cohort Study (MACS) , Women's Interagency HIV Study (WIHS) , North American AIDS Cohort Collaboration on Research and Design (NA‐ACCORD) , and an electronic medical record (EMR) study at a health care centre in New York City . Despite recent publications, however, robust prevalence estimates based on recent data are largely unavailable: data collection for the aforementioned studies occurred mostly prior to 2010, metabolic variables were often reported as baseline covariates in longitudinal analyses or in smaller substudies focused on other health outcomes, and restrictive analytic inclusion/exclusion criteria have sometimes resulted in study samples that were not representative of the larger population of HIV‐infected patients (Table ).…”

Epidemiology of ischemic heart disease in HIV

“…Moreover there is not consistent evidence of compliance with guidelines. Multiple studies have demonstrated underuse of lipid-lowering therapy or statins, 85–88 anti-hypertensives 85, 88 and aspirin 87, 89 in HIV populations. In contrast, a study from the Women’s Interagency HIV Study (WIHS) cohort showed HIV-infected women to have better controlled hypertension and diabetes compared with HIV-uninfected women.…”

Recent 5-Year Findings and Technological Advances in the Proteomic Study of HIV-Associated Disorders

“…An increasing number of HIV-infected individuals are reported nowadays to develop HIV-related cardiovascular disorders (HRCDs) despite a significant reduction in the viral load after antiretroviral therapy. People living with HIV infection are 50% −100% more likely to develop HRCDs than people without HIV infection [80], [81], [82]. In HIV-infected cell lines, 12 proteins have been found to be over-expressed in the plasma membrane or endoplasmic reticulum membrane, including myosin heavy chain cardiac muscle αisoform (MHC-α) and ryanodine receptor-1 (RyR1) [74].…”