Antiretroviral therapy and cardiovascular risk

Ridha, Essra; Devitt, Emma; Boffito, Marta; Boag, Fiona

doi:10.1136/bcr.10.2010.3429

Cited by 3 publications

(5 citation statements)

References 8 publications

(8 reference statements)

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“…Chronic immune activation, chronic inflammation, and progressive depletion of CD4+ T-cells experienced by PLHIV have been associated with the development of cardiovascular and metabolic comorbidities, including coronary plaque development, direct myocardial injury, left ventricular dysfunction, accelerated bone resorption, suppression of bone remodeling, and fractures (Carr, 2008; Hileman, Labbato, Storer, Tangpricha, & McComsey, 2014; Longenecker, Sullivan, & Baker, 2015; McComsey et al, 2010; Stein & Hsue, 2012). Furthermore, certain HIV treatments have been linked to dyslipidemia, insulin resistance, and bone loss, further increasing their risk for the development of comorbid conditions and acute cardiovascular and metabolic health complications (Anastos et al, 2007; Bedimo, Maalouf, Zhang, Drechsler, & Tebas, 2012; Brown et al, 2009; Brown & Qaqish, 2006; Calmy et al, 2013; Carr, 2008; Daria et al, 2011; Hileman et al, 2014; McComsey et al, 2010; Mueller et al, 2010; Mulligan et al, 2012; Ridha, Devitt, Boffito, & Boag, 2011). Compounding the risks is HIV and its treatment.…”

Section: Aging With Hivmentioning

confidence: 99%

“…Research on physical activity patterns in PLHIV is ongoing (Webel et al, 2015), but researchers have found that engaging in regular physical activity has the potential to reduce cardiovascular health events and symptom distress (Carr, 2008; Hileman et al, 2014; McComsey et al, 2010; Ridha et al, 2011) and to mitigate the impact of bone loss (Cotter & Mallon, 2012). Poverty is common in populations highly affected by HIV (CDC, 2015), and access to a public facility for exercise may not be an option.…”

Section: Promotion Of Self-management Behaviormentioning

confidence: 99%

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People Living With HIV: Implications for Rehabilitation Nurses

Perazzo¹,

Webel²,

McGough³

et al. 2018

Rehabilitation Nursing

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Purpose To present a brief overview of challenges faced by people living with HIV (PLHIV) as they age, to discuss the relevance of HIV to rehab nurses, and to provide evidence-based recommendations for rehabilitation professionals working with PLHIV. Design Current Issues Article Methods Literature review related to age-related comorbidities in PLHIV with implications for rehabilitation nurses. Conclusions PLHIV experience higher rates of age-related comorbidities compared to the general population and will require rehabilitation expertise in their healthcare. Understanding unique characteristics of PLHIV as well as applying focused assessment and tailored interventions in PLHIV will give rehabilitation nurses the tools to successfully guide PLHIV through the rehabilitation process and optimize clinical outcomes. Clinical Relevance As people with HIV age and experience acute and chronic comorbidities, they will require the clinical expertise of rehabilitation nurses in the process to successfully transition through acute and sub-acute healthcare and regain function.

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Section: Aging With Hivmentioning

confidence: 99%

Section: Promotion Of Self-management Behaviormentioning

confidence: 99%

People Living With HIV: Implications for Rehabilitation Nurses

Perazzo¹,

Webel²,

McGough³

et al. 2018

Rehabilitation Nursing

View full text Add to dashboard Cite

show abstract

“…Chronic immune activation, chronic inflammation, and progressive depletion of CD4+ T-cells experienced by PLHIV have been associated with the development of cardiovascular and metabolic comorbidities, including coronary plaque development, direct myocardial injury, left ventricular dysfunction, accelerated bone resorption, suppression of bone remodeling, and fractures (Carr, 2008;Hileman, Labbato, Storer, Tangpricha, & McComsey, 2014;Longenecker, Sullivan, & Baker, 2015;McComsey et al, 2010;Stein & Hsue, 2012). Furthermore, certain HIV treatments have been linked to dyslipidemia, insulin resistance, and bone loss, further increasing their risk for the development of comorbid conditions and acute cardiovascular and metabolic health complications (Anastos et al, 2007;Bedimo, Maalouf, Zhang, Drechsler, & Tebas, 2012;Brown et al, 2009;Brown & Qaqish, 2006;Calmy et al, 2013;Carr, 2008;Daria et al, 2011;Hileman et al, 2014;McComsey et al, 2010;Mueller et al, 2010;Mulligan et al, 2012;Ridha, Devitt, Boffito, & Boag, 2011). Compounding the risks is HIV and its treatment.…”

Section: Aging With Hivmentioning

confidence: 99%

“…Engagement in physical activity includes structured exercise and general (aka "free-life") physical activity that individuals perform in their everyday lives. Research on physical activity patterns in PLHIV is ongoing (Webel et al, 2015), but researchers have found that engaging in regular physical activity has the potential to reduce cardiovascular health events and symptom distress (Carr, 2008;Hileman et al, 2014;McComsey et al, 2010;Ridha et al, 2011) and to mitigate the impact of bone loss (Cotter & Mallon, 2012). Poverty is common in populations highly affected by HIV (CDC, 2015), and access to a public facility for exercise may not be an option.…”

Section: Physical Activitymentioning

confidence: 99%

People Living With HIV: Implications for Rehabilitation Nurses

2018

Rehabilitation Nursing

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Purpose-To present a brief overview of challenges faced by people living with HIV (PLHIV) as they age, to discuss the relevance of HIV to rehab nurses, and to provide evidence-based recommendations for rehabilitation professionals working with PLHIV. Design-Current Issues ArticleMethods-Literature review related to age-related comorbidities in PLHIV with implications for rehabilitation nurses.Conclusions-PLHIV experience higher rates of age-related comorbidities compared to the general population and will require rehabilitation expertise in their healthcare. Understanding unique characteristics of PLHIV as well as applying focused assessment and tailored interventions in PLHIV will give rehabilitation nurses the tools to successfully guide PLHIV through the rehabilitation process and optimize clinical outcomes.Clinical Relevance-As people with HIV age and experience acute and chronic comorbidities, they will require the clinical expertise of rehabilitation nurses in the process to successfully transition through acute and sub-acute healthcare and regain function.

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“…ART promotes different metabolic disturbances, including hepatic and neurotoxicities, lipodystrophy syndrome, hyperlactatemia, hyperlipidemia, and insulin resistance [47,48] . The present study demonstrates that HHcy can be included on this list.…”

Section: Studymentioning

confidence: 99%

Elevated homocysteine levels in human immunodeficiency virus-infected patients under antiretroviral therapy: A meta-analysis

Deminice

Silva

Oliveira

2015

WJV

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AIM:To evaluate the association between the levels of homocysteine (Hcy), folate, vitamin B12 in human immunodeficiency virus (HIV)-infected patients who were treated with antiretroviral therapy (ART) or not treated with ART. METHODS:The PubMed and Scielo databases were searched. Eligible studies regarding plasma Hcy level in HIV-infected patients were firstly identified. After careful analysis by two independent researches, the identified articles were included in the review according to two outcomes (1) Hcy, folate and vitamin B12 blood concentration in HIV-infected subjects vs health controls and; (2) Hcy blood concentration in HIV-infected subjects under ART vs not treated with ART. RevMan (version 5.2) was employed for data synthesis. RESULTS:A total of 12 studies were included in outcome 1 (1649 participants, 932 cases and 717 controls). Outcome 1 meta-analysis demonstrated higher plasma Hcy (2.05 µmol/L; 95%CI: 0.10 to 4.00, P < 0.01) and decreased plasma folate concentrations (-2.74 ng/mL; 95%CI: -5.18 to -0.29, P < 0.01) in HIV-infected patients compared to healthy controls. No changes in vitamin B12 plasma concentration were observed between groups. All studies included in the outcome 2 meta-analysis (1167 participants; 404 HIVinfected exposed to ART and 757 HIV-infected non-ART patients) demonstrated higher mean Hcy concentration in subjects HIV-infected under ART compared to non-ART HIV subjects (4.13 µmol/L; 95%CI: 1.34 to 6.92, P < 0.01). CONCLUSION:This meta-analysis demonstrated that the levels of Hcy and folate, but not vitamin B12, were associated with HIV infection. In addition, Hcy levels were higher in HIV-infected patients who were under ART compared to HIV-infected patients who were not exposed to ART. Our results suggest that hyperhomocysteinemia should be included among the several important metabolic disturbances that are associated with ART in patients with HIV infection. 147 META-ANALYSIS

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Antiretroviral therapy and cardiovascular risk

Cited by 3 publications

References 8 publications

People Living With HIV: Implications for Rehabilitation Nurses

People Living With HIV: Implications for Rehabilitation Nurses

People Living With HIV: Implications for Rehabilitation Nurses

Elevated homocysteine levels in human immunodeficiency virus-infected patients under antiretroviral therapy: A meta-analysis

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