Effects of antiretroviral therapy on arterial stiffness in Cameroonian HIV-infected patients

Ngatchou, William; Lemogoum, Daniel; Ndobo, Pierre; Yiagnigni, Euloge; Tiogou, Emiline; Nga, Elisabeth; Kouanfack, Charles; Nde, Francis; Degaute, Jean-Paul; Borne, Philippe van de; Leeman, Marc

doi:10.1097/mbp.0b013e328363ee43

Cited by 14 publications

(12 citation statements)

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“…According to Monsuez et al [19] the molecular mechanisms by which HIV-1 induces endothelial dysfunction are multifactorial with several theories linking them with combinations of high viral load, elevated inflammatory markers and adhesion molecules, pro-atherogenic lipid profile and the effects of cART. Contrary to our findings, a study in sub-Saharan Africa found higher prevalence of MS and increased arterial stiffness in cART-naïve HIV-infected individuals compared to healthy individuals in Cameroon [20]. However, the study did not involve either HIV-infected individual on cART or stratify the groups according to MS status.…”

Section: Discussioncontrasting

confidence: 99%

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

et al. 2018

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BackgroundEffective combined antiretroviral therapy (cART) has improved life expectancy among people living with HIV-1 infection. Treated HIV-1infection increases the prevalence of metabolic syndrome (MS). Despite sub-Saharan Africa having among the highest rates of HIV-1 infection, the effects of MS in HIV-1-infected individuals on cardiovascular risk is poorly explored. The aim of the study was to assess whether MS and/or HIV-1 treatment correlates with large elastic artery stiffness in HIV-1-infected patients treated with first-line cART.MethodsThe study sample comprised of 102 subjects free of cardiovascular disease and major risk factors divided into two groups based on HIV-1 infection, treatment, and MS status: HIV-1+/cART+/MS+ (n = 12); HIV-1+/cART−/MS+ (n = 16); HIV-1−/ MS+ (n = 10); HIV-1+/cART+/MS− (n = 42); HIV-1+/cART−/MS− (n = 32); HIV-1−/ MS− (n = 39). MS was established according the International Diabetes Federation definition. Large artery stiffness was measured using applanation tonometry to assess aortic pulse wave velocity (aPWV) and aortic augmentation index at heart rate of 75 bpm (AIx@HR75). cART included lamivudine/zidovudine and nevirapine or efavirenz.ResultsThe prevalence of MS in the HIV-1-infected patients was 28%. There were no significant differences in aPWV in the non-MS groups. However, in subjects with MS, aPWV was significantly higher in the HIV-1 cART patients (9.0 ± 1.9 m/s) compared with both controls (7.5 ± 1.8 m/s; P = 0.018) and untreated HIV-1 patients (7.7 ± 1.3 m/s; P = 0.023), and these differences remained after adjustment for blood pressure and sex. Aortic PWV was significantly elevated (P = 0.009) in HIV-1 cART patients with MS compared to their counterparts without MS. Untreated HIV-1 patients with MS also demonstrated increased aPWV compared to their counterparts without MS (P = 0.05). Aortic AIx@HR75 was, on average, ~ 5% higher in HIV-1 cART patients with MS (28.3 ± 62% compared with untreated HIV-1 patients with MS (23.5 ± 9%; P = 0.075). Sub-group multivariate analysis identified MS as an independent predictor of increased aPWV in HIV-1 cART patients.ConclusionsOur study established that presence of MS in HIV-1 patients on treatment was associated with increased aPWV and hence increased arterial stiffness in sub-Saharan African HIV-1 patients on first-line cART.

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Section: Discussioncontrasting

confidence: 99%

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

et al. 2018

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“…Also, our study as well showed that compared with ART naïve a group, the risk of MS was less likely in the ART exposed PLHIVs. It was consistent with several previous studies [26,35,40,49]. Correlating with our finding, G.T.…”

Section: Discussionsupporting

confidence: 94%

Predictors of metabolic syndrome among people living with HIV in the Gedeo-Zone, Southern-Ethiopia: an unmatched case-control study

Bune

Yalew

Kumie

2020

Preprint

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BackgroundMetabolic syndrome (MS) among people living with HIV (PLHIVs) is a global public health issue. However, there is no primary data about predictors of MS in the SSA and Ethiopia. Therefore, the aim of this study was to determine predictors of MS, among PLHIVs in the Gedeo-Zone,Southern-Ethiopia.MethodsUnmatched case-control study approach, among PLHIVs who served at randomly chosen two hospitals and health centers in the zone, in between (December 29th-2017 and January 22nd-2019) was done. WHO-steps tools were used to gather the data, finally handled with (Epidata-V-3.1 and SPSS-V-22) software’s. Lastly, using a multivariable conditional-LR-model, 4-models with AOR (95%CI) were computed to arrived at the final model, and then variables accepted as significant at (p-value < 0.05)level. ResultOverall, 633 PLHIVs (139 cases and 494 controls) were included in the analysis. The leading factors associated with MS were Age(>/=45years-old)(AOR=4.0,95%CI: 1.4-11.9), completed secondary school education (AOR=0.1,95% CI:0.01-0.5), un-employed(a home-maker AOR=0.1,95%CI:0.03-0.7 vs able to work AOR=0.1,95%CI:0.06-0.5)),Antiretroviral-therapy-exposed(AOR=0.1,95%CI:1.0-8.5),WHO-stage(>/=III)(AOR=4.4,95% CI:1.4-13.4), total physically activity (AOR=0.1,95% CI:0.04- 0.35), history of blood sugar measured (AOR=10.7,95%CI:3.3-34.6), elevated waist-circumference(AOR=6.9,95%CI:2.5-18.7),raised body mass index(AOR=5.4 95% CI: 1.6,18.4),fasting-glucose(AOR=29.3,95%CI:10.0-85.4),raisedtriglyceride(AOR=4.8,95%CI:2.0-11.3), and low high density lipoprotein(AOR=12.3 95% CI: 5.2,29.3). ConclusionThe finding implicated, the significance of planning intervention actions that targets the above factors in to account.

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“…The higher prevalence of hypertension among the HIV-negative individuals compared to PWH, did not support the hypothesis that PWH are at increased risk of hypertension because of increased the HIV virus and ART use leading to immune activation [ 30 , 31 ]. Previous studies assessing hypertension by HIV status have yielded conflicting results [ 20 , 21 , 32 ] Population-based surveys conducted in Uganda and North Tanzania also found higher rates of hypertension in HIV-negative individuals compared to PWH (14% vs 11% in Uganda and 8.2% vs 5.3% in Tanzania) [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 97%

Prevalence and factors associated with hypertension among adults with and without HIV in Western Kenya

et al. 2022

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Introduction The burden of cardiovascular disease (CVD) is increasing in sub-Saharan Africa with untreated hypertension being a major contributing factor. Understanding the magnitude of the problem and risk factors associated with HIV and long-term antiretroviral therapy (ART) is critically important for designing effective programs for diagnosing and treating hypertension in Kenya. Methods In this cross-sectional study, we enrolled 300 persons with HIV (PWH) on long term ART (≥6 months) and 298 HIV-negative adults seeking care at the Kisumu County Hospital between September 2017 and May 2018. Hypertension was defined as blood pressure of ≥140/90mmHg or a previous hypertension diagnosis. Multivariate regression was used to assess the association between hypertension and HIV adjusting for age, sex, and known CVD risk factors. Results Overall prevalence of hypertension was 22%. PWH had a lower prevalence of hypertension than HIV-negative persons (16% vs 27% respectively; p<0.002). In multivariate analyses, persons with HIV were 37% less likely to have hypertension compared to HIV-negative individuals (adjusted prevalence ratio 0.63; 95% confidence interval: 0.46–0.86). Other factors that were associated with hypertension in all participants included older age >40 years, body mass index (BMI) >25 kg/m2 and low-density lipoproteins ≥130mg/dL. Among PWH, being older than 40 years and higher BMI >30 kg/m2 were associated with hypertension. Conclusion Prevalence of hypertension was high, affecting nearly one in every 4 adults, and associated with older age, higher BMI and high low-density lipoproteins. PWH on long-term ART had significantly lower prevalence of hypertension compared to HIV-negative individuals, potentially due to increased access to healthcare services and interaction with prevention messaging. Interventions to increase screening for and prevention of hypertension in the community for all adults are warranted.

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Effects of antiretroviral therapy on arterial stiffness in Cameroonian HIV-infected patients

Abstract: This study shows that pulse pressure and AI were increased in HIV-T patients, compared with matched HIV-UT patients, suggesting that highly active antiretroviral therapy could increase cardiovascular risk. However, PWV was not accelerated in HIV-T patients.

Cited by 14 publications

References 0 publications

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

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

Predictors of metabolic syndrome among people living with HIV in the Gedeo-Zone, Southern-Ethiopia: an unmatched case-control study

Prevalence and factors associated with hypertension among adults with and without HIV in Western Kenya

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