Risk factors for cardiovascular disease in HIV/AIDS patients treated with highly active antiretroviral therapy (HAART) in the central-southern region of the state of Paraná – Brazil

Abstract

The aim of this study was to describe metabolic changes in HIV/AIDS patients according to the treatment regimen. It was a retrospective cohort conducted from 2002 to 2014. Researchers surveyed clinical variables and treatment regimen of 538 individuals. They used measures of central tendency and marginal logistic regression to determine the influence of the treatment regimen on clinical variables over time; survival was estimated using Kaplan-Meier curves. 56.2% of patients were male, 82.2% white, 33.8% had 4 to 7 years of study, 49.2% were married, 98.5% had sexual transmission, and 89.0% were heterosexuals. During the study period, 24.4% had hypertension, 18.2% changed cholesterol, 39.7% low HDL, 51.3% high triglycerides and 33.3% hyperglycemia. Treatment regimens with nucleotide reverse transcriptase inhibitors associated with protease inhibitors, and the association of different classes of antiretrovirals have been associated with greater lipid changes. Higher metabolic changes were observed in patients with longer treatment time. It is concluded that preventive measures, as well as early treatment, can contribute to minimize the risks of developing cardiovascular diseases.

Comparison of Tolerability and Impact on Metabolic Profiles of Antiretroviral Regimens Containing Darunavir/Ritonavir or Darunavir/Cobicistat in Romanian HIV Infected Patients

“…Most studies associate the increased risk of cardiovascular disease with ART's duration. They emphasized the importance of early treatment and identification of patients' risk profiles [67,68].…”

Epidemiological and Metabolic Profile of Women Living With HIV/AIDS in Campos Gerais: 2008-2017

“…The patients in this study had a percentage difference of 14.2% in glycemia and 17.6% in cholesterol between 2008 and 2017, in this case, it is verified that ART is associated with adverse complications, of which some are serious, such as metabolic disorders of glucose intolerance and diabetes, as well as lipid disorders, leading to an increase in Metabolic Syndrome (MS) and cardiovascular disease (CVD) [10,23]. However, a descriptive study on cardiovascular risk factors in HIV/ AIDS patients according to the therapeutic regimen used concluded that preventive measures as well as early treatment can contribute to minimize the risks of developing cardiovascular diseases caused by HIV infection [24]. No woman in this study used it in 2008 and 1.8% used it in 2017.…”

Manejo de pacientes VIH con alto riesgo cardiovascular

“…(6). Se observó un considerable aumento en la expectativa de vida, debido a una reducción en la mortalidad, y esto se refleja en la mortalidad que se asemeja a la de la población en general (7). El incremento en la expectativa de vida exhibió un nuevo grupo de comorbilidades, la osteopenia, y los síndromes geriátricos, que antes no representaban relevancia en pacientes con VIH, ahora, son temas para intervenir.…”

“…Se ha asociado un aumento en el riesgo cardiovascular en los pacientes con VIH. Ese riesgo se atribuye a los siguientes factores: intrínsecos del paciente (sexo e historia familiar), propios del VIH (activación inmunitaria, inflamación e inmunodeficiencia), y asociados a la terapia antirretroviral (alteraciones metabólicas) (7). Es importante mencionar que dentro de los factores intrínsecos del paciente está el sexo masculino, los hombres tienen mayor riesgo cardiovascular que las e327 mujeres debido a un efecto protector de los estrógenos en la etapa fértil de la mujer (6).…”