High Prevalence of Echocardiographic Abnormalities among HIV-infected Persons in the Era of Highly Active Antiretroviral Therapy

Mondy, Kristin; Gottdiener, John S.; Overton, Edgar Turner; Henry, Keith; Bush, Timothy J.; Conley, Lois J.; Hammer, John; Carpenter, Charles C. J.; Kojic, Erna M.; Patel, Parul; Brooks, JT

doi:10.1093/cid/ciq066

Cited by 155 publications

(189 citation statements)

References 44 publications

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“…Although Mondy and colleagues did not find a significant association between HCV and PH, HIV-HCV coinfection was associated with left ventricular hypertrophy and left ventricular systolic dysfunction (24). In our study, the relationships between IFN treatment and echocardiographic outcomes persisted after adjustment for left atrial enlargement (although precision was poorer), echocardiographic diastolic Definition of abbreviations: ART = antiretroviral therapy; CI = confidence interval; HCV = hepatitis C virus; HIV = human immunodeficiency virus; IFN = interferon.…”

Section: Original Researchmentioning

confidence: 86%

“…The Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy (SUN Study) reported echocardiographic abnormalities in 656 HIV-infected patients, 84 (13%) of whom were coinfected with HCV (24). Although Mondy and colleagues did not find a significant association between HCV and PH, HIV-HCV coinfection was associated with left ventricular hypertrophy and left ventricular systolic dysfunction (24).…”

Section: Original Researchmentioning

confidence: 99%

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Risk of Echocardiographic Pulmonary Hypertension in Individuals with Human Immunodeficiency Virus–Hepatitis C Virus Coinfection

et al. 2014

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Rationale: Human immunodeficiency virus (HIV) infection is a risk factor for pulmonary hypertension (PH). Chronic hepatitis C virus (HCV) infection may have unique or synergistic effects on the pulmonary vasculature, but the prevalence and risk factors for PH in HIV-HCV coinfected persons are not known.Objectives: To define the prevalence of echocardiographic PH in a cohort of patients with HIV-HCV coinfection, to compare this estimate with the reported prevalence of PH among those with HIV infection alone, and to identify potential risk factors for PH in coinfected individuals.Methods: We performed a retrospective study of HIV-HCV coinfected patients followed at our institution from 2003 to 2012 with evidence of HCV infection (positive HCV antibody, measurable HCV ribonucleic acid viral load, and/or genotype) within 6 months of transthoracic echocardiogram. PH was defined by an estimated pulmonary artery systolic pressure (PASP) of greater than or equal to 40 mm Hg or more than moderate right ventricular dysfunction. We excluded those diagnosed with cirrhosis, left ventricular ejection fraction less than 50%, or more than moderate aortic or mitral valve disease. Measurements and Main Results:Sixty-eight patients were included, and 43 had adequate estimates of PASP. The median (interquartile range) age was 52 (48-57) years, and 45 (67%) were men. Eight (19%) had PH, and three (7%) had more than moderate right ventricular dysfunction. After age and sex adjustment, interferon (IFN)-based HCV treatment was associated with higher PASP (b, 6.00 mm Hg; 95% confidence interval, 0.09-11.90; P = 0.047) and with the risk of PH (odds ratio, 5.65; 95% confidence interval, 1.07-29.93; P = 0.042). These associations persisted after adjustment for comorbidities but were attenuated by adjustment for duration of HCV diagnosis. Conclusions:The prevalence of echocardiographic PH may be higher in HIV-HCV coinfected individuals than in those with HIV monoinfection. IFN-based HCV treatment and time since HCV diagnosis were associated with the development of PH as assessed by echocardiography. Further studies are needed to examine HIV-HCV coinfection, HCV treatment, and duration of infection as possible causes of pulmonary vascular disease.

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Section: Original Researchmentioning

confidence: 86%

Section: Original Researchmentioning

confidence: 99%

Risk of Echocardiographic Pulmonary Hypertension in Individuals with Human Immunodeficiency Virus–Hepatitis C Virus Coinfection

et al. 2014

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“…7 Similar study on HIV positive subjects had shown the prevalence of 10 % with older age, diabetes and hypertension as the common risk factors. 8 Data regarding the burden of AIHD among hospital visiting patients and associated risk factors for IHD among them was not seen in literature.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Ischemic Heart Disease and its Risk Factors among Asymptomatic Hospital Visitors

Asmathulla

Ragunathan

Ramchandar

2013

Int J of Biomed & Adv Res

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Objectives: The prevalence of Ischemic Heart Disease (IHD) and risk factors of IHD is increasing in developing countries, including India due to changes in lifestyle and dietary changes. Reports regarding asymptomatic ischemic heart disease (AIHD) among general population showed varying results. Studying the prevalence and associated risk factors of AIHD among the hospital visiting population is worthwhile.

Materials & Methods: One hundred patients attending a tertiary care hospital, not known to have IHD or symptoms of IHD were included. ECG was recorded and IHD was diagnosed using Minnesota criteria. After collecting blood for lipid profile, height, weight, waist circumference (WC) and hip circumference (HC) were measured.

Results & Discussion: Among the study population, males (n=57) had increased age and height compared to females (n=43). HC, WC and body mass index (BMI) were increased in females compared to males. Among IHD risk factors BMI, WC and waist-hip ratio (WHR) were positively correlated with systolic BP and diastolic BP. The incidence of AIHD was found to be 13% among the study group. Compared to non-ischemic group age factor, triglycerides (TGL) and VLDL cholesterol were significantly elevated among AIHD subjects. On regression analysis, age and TGL were found to be independent risk factors to develop AIHD among this study population.

Conclusion: Prevalence of AIHD among hospital visiting patients is 13%. Age, TAG and VLDL were significantly increased in AIHD subjects compared to controls. Further regression analysis revealed age and TAG as associated risk factors to develop AIHD in this study population.

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“…7,8 The presence of HIV/AIDS-associated comorbidity and co-infections have necessitated the concurrent use of SMX/TMP and antiretroviral medications containing LPV/r which have been shown to be of clinical benefits. 9 The concurrent use of LPV/r with SMX/TMP may possibly place more toxicological burden on the heart which pumps blood that serves as a means of drug transportation.…”

mentioning

confidence: 99%

Effect of co-administered lopinavir/ritonavir and sulfamethoxazole/trimethoprim on cardiac function and architecture of albino rats

Adikwu

Oputiri²,

Jimmy³

et al. 2014

Int J Basic Clin Pharmacol

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High Prevalence of Echocardiographic Abnormalities among HIV-infected Persons in the Era of Highly Active Antiretroviral Therapy

Cited by 155 publications

References 44 publications

Risk of Echocardiographic Pulmonary Hypertension in Individuals with Human Immunodeficiency Virus–Hepatitis C Virus Coinfection

Risk of Echocardiographic Pulmonary Hypertension in Individuals with Human Immunodeficiency Virus–Hepatitis C Virus Coinfection

Assessment of Ischemic Heart Disease and its Risk Factors among Asymptomatic Hospital Visitors

Effect of co-administered lopinavir/ritonavir and sulfamethoxazole/trimethoprim on cardiac function and architecture of albino rats

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