High-sensitivity C-reactive protein levels in HIV-infected patients treated or not with antiretroviral drugs and their correlation with factors related to cardiovascular risk and HIV infection

Guimarães, Milena Maria Moreira; Greco, Dirceu Bartolomeu; Figueiredo, Sônia Maria de; Fóscolo, Rodrigo Bastos; Oliveira, Antônio Ribeiro de; Machado, Lucas José de Campos

doi:10.1016/j.atherosclerosis.2008.02.003

Cited by 37 publications

(32 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The potential for such patient-centered efficiency gains is likely to increase over the coming decades as continuously rising ART coverage will increase the co-prevalence of HIV and NCD. This increase will be driven by a new epidemiological transition in SSA through several important pathways [2] (Geldsetzer et al in press): ART allows patients with HIV to survive into the older ages when NCD become very common [3]; the aging process in people surviving on ART is accelerated by chronic HIV inflammation that is not eliminated by ART [15–17]; and several ARVs have side effects that cause NCD [18]. …”

Section: New Models Of Carementioning

confidence: 99%

The efficiency of chronic disease care in sub-Saharan Africa

Geldsetzer

Ortblad

Bärnighausen

2016

BMC Med

View full text Add to dashboard Cite

The number of people needing chronic disease care is projected to increase in sub-Saharan Africa as a result of expanding human immunodeficiency virus (HIV) treatment coverage, rising life expectancies, and lifestyle changes. Using nationally representative data of healthcare facilities, Di Giorgio et al. found that many HIV clinics in Kenya, Uganda, and Zambia appear to have considerable untapped capacity to provide care for additional patients. These findings highlight the potential for increasing the efficiency of clinical processes for chronic disease care at the facility level. Important questions for future research are how estimates of comparative technical efficiency across facilities change, when they are adjusted for quality of care and the composition of patients by care complexity. Looking ahead, substantial research investment will be needed to ensure that we do not forgo the opportunity to learn how efficiency changes, as chronic care is becoming increasingly differentiated by patient type and integrated across diseases and health systems functions.Please see related article: http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-016-0653-z

show abstract

Section: New Models Of Carementioning

confidence: 99%

The efficiency of chronic disease care in sub-Saharan Africa

Geldsetzer

Ortblad

Bärnighausen

2016

BMC Med

View full text Add to dashboard Cite

show abstract

“…66 In the SMART study, 1 month after stopping treatment, HIV RNA levels were associated with increases in D-dimer and IL-6 levels, and baseline D-dimer and IL-6 levels were strongly associated with an increased risk of all-cause mortality. 67 Compared with HIV-negative patients, treated HIVpositive patients have higher levels of inflammatory markers such as high sensitivity CRP, IL-6, D-dimer and cystatin C. 15 Higher CRP levels are reported in ART-treated versus naïve patients, 68 and data from the Study of Fat Redistribution and Metabolic Change in HIV Infection (FRAM) showed an increase in fibrinogen and CRP compared with HIV-negative patients, and among patients on PIs compared with patients receiving NNRTIs. 69 Although these markers of inflammation are higher in untreated HIV infection, they do not seem to be fully reversed with effective cART.…”

Section: Hiv Infectionmentioning

confidence: 99%

HIV infection, aging and cardiovascular disease: epidemiology and prevention

Petoumenos

Worm

2011

Sex. Health

View full text Add to dashboard Cite

Abstract. In the developed world, HIV infection is now well managed with very effective and less toxic antiretroviral treatment. HIV-positive patients therefore are living longer, but are now faced by challenges associated with aging. Several non-AIDS associated morbidities are increased in this population, including cardiovascular disease (CVD). It is suggested that CVD occurs earlier among HIV-positive patients compared with HIV-negative patients, and at a higher rate. Several factors have been proposed to contribute to this. First, the traditional CVD risk factors are highly prevalent in this population. High rates of smoking, dyslipidaemia and a family history of CVD have been reported. This population is also aging, with estimates of more than 25% of HIV-positive patients in the developed world being over the age of 50. Antiretroviral treatment, both through its effect on lipids and through other, sometimes less well understood, mechanisms, has been linked to increased CVD risk. HIV infection, especially untreated, is a further contributing factor to increased CVD risk in HIV-positive patients. As the HIV-positive population continues to age, the risk of CVD will continue to increase. Guidelines for the management and prevention of CVD risk have been developed, and are largely modelled on those used in the general population. However, the data currently suggest that these interventions, such as the use of lipid-lowering medications and smoking cessation programs, remain quite low. A better understanding the mechanisms of CVD risk in this aging population and further efforts in improving uptake of prevention strategies will remain an important research area.

show abstract

“…Immune activation is an important consequence of HIV infection as it correlates with a number of morbidities, either virus related or not, as listed in the introduction [8][9][10][11]. A persistent state of immune activation is also related to CD4+ T cells depletion during untreated infection and to viral blips during cART [4][5][6][7][8].…”

Section: Discussionmentioning

confidence: 99%

“…Persistent immune activation is linked with a number of negative consequences. Levels of immune activation are associated with the risk of viral blips during cART and with persistent low-level viral replication [8,9], and immune activation in turn activates coagulation and endothelium, leading to morbidities such as metabolic syndrome, liver steatosis, atherosclerosis, neurocognitive disorders, kidney failure, osteoporosis and probably some types of cancer [10,11]. Immune activation also contributes to a more rapid aging of the immune system of which CD57+CD8+ lymphocytes percentage and absolute numbers are markers [12].…”

Section: Introductionmentioning

confidence: 99%

Lack of Difference between the Reduced Dose and Full-Dose of Antiretroviral Therapy in Terms of the Decrease in Immune Activation

Nicolè¹,

Cucchetto²,

Lanzafame³

et al. 2017

Ann Antivir Antiretrovir

View full text Add to dashboard Cite

Virological and immunological effectiveness of reduced doses of antiretrovirals has been shown in two randomized trials and smaller studies. We have now evaluated immune activation in patients on reduced doses of antiretroviral therapy (ART) using HLA-DR+CD8+ lymphocytes as a marker of activation. In an observational, retrospective study we assessed 113 HIV-infected patients who switched from standard combined ART (cART) to reduced dose combinations (cohort 1), while maintaining virological suppression (<20 copies/mL). After a mean time of 36 months on reduced dose therapy, the mean increase in CD4+ lymphocyte numbers was 100 cell/μL (p<0.01) and the mean reduction of HLA-DR+ lymphocytes was 103 cells/μL (p<0.01). We also compared cohort 1 with a cohort of 113 virologically suppressed patients on standard cART (cohort 2). We found no signifi cant differences in the number of CD4+ lymphocytes or in immune activation (mean values of HLA-DR+ absolute number and percentage of total CD8+ lymphocytes). The results of this retrospective study did not identify any immunological differences between reduced antiretroviral dose regimens and standard cART and suggest that reduced dose regimens can progressively reduce immune activation similarly to standard cART.

show abstract

High-sensitivity C-reactive protein levels in HIV-infected patients treated or not with antiretroviral drugs and their correlation with factors related to cardiovascular risk and HIV infection

Cited by 37 publications

References 25 publications

The efficiency of chronic disease care in sub-Saharan Africa

The efficiency of chronic disease care in sub-Saharan Africa

HIV infection, aging and cardiovascular disease: epidemiology and prevention

Lack of Difference between the Reduced Dose and Full-Dose of Antiretroviral Therapy in Terms of the Decrease in Immune Activation

Contact Info

Product

Resources

About