Cardiovascular Disease and Cardiovascular Disease Risk in HIV-Positive Populations in the Asian Region

Bijker, Rimke; Choi, Jun Yong; Ditangco, Rossana; Kiertiburanakul, Sasisopin; Lee, Man Po; Siwamogsatham, Sarawut; Pujari, Sanjay; Ross, Jeremy; Wong, Chi Yuen; Wong, Wing Wai; Yunihastuti, Evy; Law, Matthew

doi:10.2174/1874613601711010052

Cited by 15 publications

(9 citation statements)

References 45 publications

(85 reference statements)

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“…However, most of these studies have been confined to Western populations [1, 5–12, 15–17]. Little is known regarding the association between HIV infection and the risk of stroke in Asian people [6, 13, 14]. Multiple factors, including age, sex, family history, the effect of HIV itself, the effect of antiretroviral therapy, traditional cardiovascular risk factors etc., influence the risk of stroke in HIV-infected individuals.…”

Section: Introductionmentioning

confidence: 99%

Incidence of stroke in patients with HIV infection: A population-based study in Taiwan

et al. 2019

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Background Few studies have evaluated whether people infected with human immunodeficiency virus (HIV) are at an increased risk of stroke in an Asian population. We investigated the association between HIV infection and the risk of developing stroke by age, calendar year of HIV diagnosis, and follow-up duration in Taiwan. Methods Using the claims data of a universal health insurance program, we identified 5,961 patients with HIV and 23,844 matched non-HIV subjects without previous stroke from 1998 to 2005 and followed them up until the end of 2011 to measure the incidence of stroke. Cox proportional hazards models adjusted for potential confounders were used to estimate hazard ratios (HR) and 95% confidence intervals (CI), with the non-HIV group as reference. Results During a median follow-up of 8 years, the incidence rates for total, ischemic, and hemorrhagic stroke per 1000 person-years were 2.12, 1.22, and 0.60, respectively, in patients with HIV infection, and 1.98, 1.14, and 0.54, respectively, in the comparison group. HIV infection was associated with an elevated risk of developing total stroke (adjusted HR [95% CI], 1.57 [1.15–2.14]) and ischemic stroke (1.91 [1.25–2.91]) in patients aged less than 45 years, but no association was observed in other age groups ( P for interaction with age, p = 0.048 and 0.024, respectively). Patients diagnosed with HIV infection in 1998–1999 had a greater HR for total stroke and ischemic stroke than those diagnosed in 2000–2002 and 2003–2005 ( P for interaction, for total stroke p = 0.034, for ischemic stroke p = 0.056). The HRs did not differ by follow-up duration. Conclusions HIV infection among a young age group is associated with increased risk of developing overall and ischemic stroke. The findings highlight the importance of screening and correcting risk factors for young stroke prevention immediately and aggressively.

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Section: Introductionmentioning

confidence: 99%

Incidence of stroke in patients with HIV infection: A population-based study in Taiwan

et al. 2019

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“…A comprehensive review of lipid levels as a risk factor for CVDs in PLWH in Asian regions (including Korea) reported that dyslipidemia was less prevalent in patients who first presented with HIV compared with in HIV-negative controls. In addition, total cholesterol levels were on average lower in HIV-positive patients, whereas findings were inconsistent regarding triglyceride levels [ 26 ]. This review also showed that ART had an unfavorable effect on blood lipid levels in Asian PLWH [ 26 ].…”

Section: Dyslipidemia and Artmentioning

confidence: 99%

Weight Gain and Metabolic Syndrome in Human Immunodeficiency Virus Patients

Chang

2022

Infect Chemother

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While human immunodeficiency virus (HIV)-associated wasting has declined with significant advances in antiretroviral therapy (ART), weight gain and metabolic syndrome (MetS) are now becoming a problem for people living with HIV (PLWH) worldwide. The development of a new and more effective ART regimen has increased viral suppression and improved immunologic function recovery, leading to the extension of the lifespan of PLWH. It has recently been reported as one of the significant factors associated with weight gain, obesity, and long-term metabolic consequences in PLWH. This article reviewed the epidemiology of overweight and MetS among PLWH and the known risk factors for weight gain and its major comorbidities, such as dyslipidemia, diabetes mellitus, cardiovascular diseases, neurocognitive disorders, and liver diseases, in PLWH. In addition, reports on the pharmacological and surgical management of overweight and obesity in PLWH has been briefly summarized.

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“…There is some guidance for CVD risk prevention and management in PLWH in Asia provided through national HIV treatment guidelines; however, these are limited in number and scope [13]. The recommendations below are based on existing data from research on CVD in PLWH, particularly those from Asia where available.…”

Section: Management Of Cvd Riskmentioning

confidence: 99%

“…Regardless of HIV status, about 50% of CVD deaths worldwide occur in Asia [10]. Asian PLWH have a high prevalence of conventional risk factors for CVD, such as smoking, dyslipidaemia, hypertension and insulin resistance or diabetes mellitus [11][12][13]. Currently, there is limited but growing interest in the research on CVD in Asian PLWH.…”

Section: Introductionmentioning

confidence: 99%

Managing cardiovascular risk in people living with HIV in Asia – where are we now?

et al. 2021

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As the life expectancy of people living with HIV (PLWH) approaches that of the general population, the burden of comorbidities such as cardiovascular disease (CVD) is increasing. Regardless of HIV status, about 50% of CVD deaths worldwide occur in Asia, and Asian PLWH have a high prevalence of conventional CVD risk factors, such as smoking, dyslipidaemia, hypertension and insulin resistance or diabetes. As well as conventional CVD risk factors, PLWH have HIV-specific risk factors such as chronic inflammation, immune activation and endothelial damage, as well as risk factors related to antiretroviral therapy. This review describes the current knowledge on the epidemiology and risk factors of CVD in Asian PLWH and provides an Asian perspective on the recommendations for managing CVD risk in PLWH.

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Cardiovascular Disease and Cardiovascular Disease Risk in HIV-Positive Populations in the Asian Region

Cited by 15 publications

References 45 publications

Incidence of stroke in patients with HIV infection: A population-based study in Taiwan

Incidence of stroke in patients with HIV infection: A population-based study in Taiwan

Weight Gain and Metabolic Syndrome in Human Immunodeficiency Virus Patients

Managing cardiovascular risk in people living with HIV in Asia – where are we now?

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