Association of HIV-infection, antiretroviral treatment and metabolic syndrome with large artery stiffness: a cross-sectional study

Msoka, Titus F.; Guilder, Gary P. Van; Smulders, Yvo M.; Furth, A. Marceline van; Bartlett, John A.; Agtmael, Michiel A. van

doi:10.1186/s12879-018-3637-0

Cited by 15 publications

(19 citation statements)

References 39 publications

(44 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Combination therapy with NRTIs and non-nucleoside reverse transcriptase inhibitors (NNRTIs) was associated with more severe stiffening of large elastic arteries in subjects with MetS than that in those without MetS or in those not receiving combined therapy [10], suggesting that regardless of the combination's contribution to MetS, it definitely exaggerates arterial remodeling.…”

Section: Role Of Hiv Infection and Art In Metabolic Syndromementioning

confidence: 99%

Hypertension and Metabolic Syndrome in Persons with HIV

et al. 2020

View full text Add to dashboard Cite

Purpose of Review With the advent of highly active antiretroviral therapy (ART), the life span of persons with HIV (PWH) has been nearly normalized. With aging, prevalence of the metabolic syndrome (MetS), including hypertension, has increased in the HIV population and exceeds that in the general population in some studies. This is due to a combination of traditional risk factors in addition to the effects attributable to the virus and ART. We review recent findings on the mechanisms contributing to MetS and hypertension in PWH, particularly those specific to the viral infection and to ART. Recent Findings Activation of the renin-angiotensin-aldosterone system (RAAS) and chronic immune activation contribute to the development of MetS and hypertension in PWH. HIV proteins and some ART agents alter adipocyte health contributing to dyslipidemias, weight gain, and insulin resistance. HIV infection also contributes to hypertension by direct effects on the RAAS that intertwine with inflammation by the RAAS also contributing to T cell activation. Summary Recent data suggest that in addition to current ART, therapeutic targeting of the MetS and hypertension in PWH, by interfering with the RAAS, treating insulin resistance directly or by use of immunomodulators that dampen inflammation, may be critical for preventing or treating these risk factors and to improve overall cardiovascular complications in the HIV-infected aging population.

show abstract

Section: Role Of Hiv Infection and Art In Metabolic Syndromementioning

confidence: 99%

Hypertension and Metabolic Syndrome in Persons with HIV

et al. 2020

View full text Add to dashboard Cite

show abstract

“…However, several concerns have been raised when adopting a CVD risk prediction algorithm for clinical assessments of HIV-infected patients. 3 Controversies on the magnitude of CVD risk among individuals according to serostatus and specific drugs in ART regimens have been reported both in studies using biomarkers (such as carotid intima-media thickness (cIMT), pulse wave velocity (PWV), and flow-mediated dilatation), 4–6 as well as in studies using different CVD risk prediction algorithms/equations. Multiple studies have compared calculated risk between HIV-infected persons (both with and without ART) and controls and found conflicting results; some studies suggesting a similar risk, 7 , 8 others an increased risk due to chronic inflammation of the HIV-infection.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Predicted Cardiovascular Risk Profiles by Different CVD Risk-Scoring Algorithms between HIV-1-Infected and Uninfected Adults: A Cross-Sectional Study in Tanzania

Msoka¹,

Rogath²,

Guilder³

et al. 2021

HIV

View full text Add to dashboard Cite

Purpose Cardiovascular disease (CVD) risk assessment is a suitable way to differentiate between high-risk individuals requiring intervention and risk modification, and those at low risk. However, concerns have been raised when adopting a CVD-risk prediction algorithm for HIV-infected patients in sub-Saharan Africa. Patients and Methods We compared cardiovascular risk profiles between HIV-infected (with and without antiretroviral therapy (ART)) and HIV-uninfected adults as predicted by the American College of Cardiology/American Heart Association (ASCVD) and the Framingham cardiovascular risk score (FRS) algorithms and assessed the concordance of the algorithms in predicting 10-year CVD risk separately in HIV-infected and uninfected groups in a hospital-based cross-sectional study in Tanzania. A cross-sectional hospital-based study including 40 HIV-infected ART-naive, 64 HIV-infected on ART, and 50 HIV-uninfected adults was conducted. Traditional cardiovascular risk factors were determined by standard investigations. The primary outcome was the absolute 10-year CVD risk score based on the two algorithms. Results Compared to HIV-uninfected, HIV-infected adults were classified at a higher 10-year CVD risk. ASCVD algorithms predicted a higher proportion of high-risk individuals compared to FRS in both HIV-infected and uninfected groups. The concordance between ASCVD and FRS-lipid algorithms was reasonable for both HIV-infected and uninfected groups though relatively higher in the HIV-uninfected group. Conclusion HIV-infected individuals have a higher 10-year cardiovascular risk compared to HIV-uninfected persons. The concordance between ASCVD and FRS-lipid algorithms is reasonable in both HIV-uninfected and infected persons in Tanzania. Development of an HIV-specific algorithm is needed to accurately predict CVD risk in this population at high-risk.

show abstract

“…3 This impact is over and above the impact of MetS on HIV-associated arterial stiffness seen in sub-Saharan African adults on ART. 13 While the metabolic disturbances resulting from ART may contribute to HIVassociated arteriosclerosis in children with PHIV, 14,15,16 this is likely far outweighed by the benefits of suppressing HIV replication. In this study we collected data from children with PHIV with sustained viral suppression (without viral blips) on longterm ART in Africa and used PWV as the outcome measure.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Earlier antiretroviral initiation is independently associated with better arterial stiffness in children living with perinatally acquired HIV with sustained viral suppression in Mozambique

Dobe

Mocumbi

Majid³

et al. 2021

Southern African Journal of HIV Medicine

View full text Add to dashboard Cite

Background: Cardiovascular disease is a major driver of morbidity and mortality in adults living with HIV. The drivers of cardiovascular disease in children living with perinatally acquired HIV (PHIV) with sustained HIV viral suppression are unclear.Objectives: We explored the contribution of HIV-specific risk factors to arterial stiffness independently of traditional risk factors (metabolic syndrome [MetS]) in prepubertal children with PHIV with sustained viral suppression in a low-income country in Africa.Method: For this cross-sectional analysis, arterial stiffness was assessed by pulse wave velocity z-score (PWVz), measured using a Vicorder device. Metabolic syndrome components were measured. We retrospectively collected the antiretroviral therapy (ART) exposures, HIV stage, CD4 count and HIV viral load. A multivariate linear regression model was constructed for MetS components, retaining age and gender as obligatory variables. We then added HIV-related metrics to assess whether these had an independent or additive effect.Results: We studied 77 virally suppressed children with PHIV without evidence of cardiovascular disease (from medical history and physical examination). In the initial model, the PWVz was independently associated with each MetS component. The PWVz was higher in participants with proportionally greater visceral fat (waist/height ratio), elevated lipids (triglyceride/high-density lipoprotein ratio) and insulin resistance (log homeostatic model assessment [HOMA]). The addition of age at ART initiation increased the model R2 value from 0.36 to 0.43. In the resulting model, younger age at ART initiation was independently associated with a better PWVz (P 0.001).Conclusion: Earlier ART initiation was independently associated with lower large artery stiffness. This effect was independent of the effect of elevated lipids, visceral fat and insulin resistance.

show abstract

Association of HIV-infection, antiretroviral treatment and metabolic syndrome with large artery stiffness: a cross-sectional study

Cited by 15 publications

References 39 publications

Hypertension and Metabolic Syndrome in Persons with HIV

Hypertension and Metabolic Syndrome in Persons with HIV

Comparison of Predicted Cardiovascular Risk Profiles by Different CVD Risk-Scoring Algorithms between HIV-1-Infected and Uninfected Adults: A Cross-Sectional Study in Tanzania

Earlier antiretroviral initiation is independently associated with better arterial stiffness in children living with perinatally acquired HIV with sustained viral suppression in Mozambique

Contact Info

Product

Resources

About