Endothelial dysfunction, a predictor of cardiovascular disease in HIV patients on antiretroviral therapy: A systematic review and meta-analysis

Strauss, Kay-Lee E.; Phoswa, Wendy N.; Lebelo, Sogolo L.; Modjadji, Perpetua; Mokgalaboni, Kabelo

doi:10.1016/j.thromres.2023.12.011

Cited by 3 publications

(3 citation statements)

References 56 publications

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“…262 A recent review and meta-analysis indicated that, overall, ART use contributes to decreased endothelial activation as evidenced by decreased VCAM-1 and ICAM-1. 263 Despite this, vascular dysfunction persists among PLWH on stable ART. 263 Indeed, in many large cohort studies, the effect of HIV serostatus on vascular function and putative mechanisms underlying CVD risk that may be modifiable by exercise in PLWH discussed in this review are robust to adjustment for ART use or persist relative to seronegative controls despite ART use.…”

Section: Art Regimens and Accelerated Vascular Aging In Plwhmentioning

confidence: 99%

“…263 Despite this, vascular dysfunction persists among PLWH on stable ART. 263 Indeed, in many large cohort studies, the effect of HIV serostatus on vascular function and putative mechanisms underlying CVD risk that may be modifiable by exercise in PLWH discussed in this review are robust to adjustment for ART use or persist relative to seronegative controls despite ART use. Finally, in vitro evidence supports that statin use may protect against endothelial oxidative stress, inflammation, senescence, and dysfunction induced by ritonavir-boosted protease inhibitors.…”

Section: Art Regimens and Accelerated Vascular Aging In Plwhmentioning

confidence: 99%

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Exercise to Prevent Accelerated Vascular Aging in People Living With HIV

Jones,

Robinson,

Beach

et al. 2024

Circulation Research

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Given advances in antiretroviral therapy, the mortality rate for HIV infection has dropped considerably over recent decades. However, people living with HIV (PLWH) experience longer life spans coupled with persistent immune activation despite viral suppression and potential toxicity from long-term antiretroviral therapy use. Consequently, PLWH face a cardiovascular disease (CVD) risk more than twice that of the general population, making it the leading cause of death among this group. Here, we briefly review the epidemiology of CVD in PLWH highlighting disparities at the intersections of sex and gender, age, race/ethnicity, and the contributions of social determinants of health and psychosocial stress to increased CVD risk among individuals with marginalized identities. We then overview the pathophysiology of HIV and discuss the primary factors implicated as contributors to CVD risk among PLWH on antiretroviral therapy. Subsequently, we highlight the functional evidence of premature vascular dysfunction as an early pathophysiological determinant of CVD risk among PLWH, discuss several mechanisms underlying premature vascular dysfunction in PLWH, and synthesize current research on the pathophysiological mechanisms underlying accelerated vascular aging in PLWH, focusing on immune activation, chronic inflammation, and oxidative stress. We consider understudied aspects such as HIV-related changes to the gut microbiome and psychosocial stress, which may serve as mechanisms through which exercise can abrogate accelerated vascular aging. Emphasizing the significance of exercise, we review various modalities and their impacts on vascular health, proposing a holistic approach to managing CVD risks in PLWH. The discussion extends to critical future study areas related to vascular aging, CVD, and the efficacy of exercise interventions, with a call for more inclusive research that considers the diversity of the PLWH population.

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Section: Art Regimens and Accelerated Vascular Aging In Plwhmentioning

confidence: 99%

Section: Art Regimens and Accelerated Vascular Aging In Plwhmentioning

confidence: 99%

Exercise to Prevent Accelerated Vascular Aging in People Living With HIV

Jones,

Robinson,

Beach

et al. 2024

Circulation Research

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“…According to the World Health Organisation report (2023), at least 39 million people live with HIV globally [1], and this population is known to be at an increased risk of cardiovascular disease [2][3][4]. Traditional cardiovascular risk factors incompletely account for this increased risk [2,[5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Cytomegalovirus Immunoglobulin G Levels and Subclinical Arterial Disease among People Living with HIV in Botswana: A Cross-Sectional Study

Moshomo,

Molefe-Baikai,

Bennett

et al. 2024

Biomedicines

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Cytomegalovirus (CMV) has been linked with increased cardiovascular risk and monocyte activation in people living with HIV (PLWH). This cross-sectional study aimed to compare CMV immunoglobulin G (IgG) levels between combined antiretroviral therapy (cART)-treated PLWH versus ART-naïve PLWH and those without HIV, and to investigate their associations with biomarkers of endothelial injury and carotid atherosclerosis, in Gaborone, Botswana. All participants were between 30 and 50 years old. Carotid intimal media thickness (cIMT) and biomarkers of endothelial injury and monocyte activation were also assessed. The association between quantitative CMV IgG and cardiovascular disease risk was assessed in multivariate logistic regression analysis. The results showed that the mean CMV IgG level among ART-naïve participants was significantly higher than both the cART group and controls. However, CMV IgG levels did not differ significantly between the controls and cART groups. Among PLWH, CMV IgG levels were associated with ICAM-1 levels and cIMT. Increases in CMV IgG among ART-naïve participants were significantly associated with increases in log VCAM-1. In conclusion, CMV IgG levels are elevated among PLWH in sub-Saharan Africa, and higher levels are associated with biomarkers of endothelial injury and cIMT. Future research should investigate the long-term impact of elevated CMV IgG among PLWH.

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A systematic review and bibliometric analysis on agribusiness gaps in emerging markets

Kwasi Bannor,

Kofi Arthur

2024

Research in Globalization

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Endothelial dysfunction, a predictor of cardiovascular disease in HIV patients on antiretroviral therapy: A systematic review and meta-analysis

Cited by 3 publications

References 56 publications

Exercise to Prevent Accelerated Vascular Aging in People Living With HIV

Exercise to Prevent Accelerated Vascular Aging in People Living With HIV

Cytomegalovirus Immunoglobulin G Levels and Subclinical Arterial Disease among People Living with HIV in Botswana: A Cross-Sectional Study

A systematic review and bibliometric analysis on agribusiness gaps in emerging markets

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