HIV and Antiretroviral Therapy Are Independently Associated with Cardiometabolic Variables and Cardiac Electrical Activity in Adults from the Western Cape Region of South Africa

Abstract

Cardiovascular-related complications are on the rise in people with HIV/AIDS (PWH); however, the relationship among HIV and antiretroviral therapy (ART)-related parameters, cardiovascular risk, and cardiac electrical activity in PWH remain poorly studied, especially in sub-Saharan African populations. We investigated whether HIV and ART are associated with cardiometabolic and cardiac electrical activity in PWH from Worcester in the Western Cape Province, South Africa. This was a cross-sectional study with HIV-negative (HIV−, n = 24) and HIV-positive on ART (HIV+/ART+, n = 63) participants. We obtained demographic, lifestyle, and medical history data and performed anthropometric, clinical assessments, and blood/urine biochemistry. We performed multiple stepwise linear regression analyses to determine independent associations among HIV, ART, cardiometabolic, and electrocardiographic (ECG) variables. HIV+/ART+ independently associated with a lower body mass index (p = 0.004), elevated gamma-glutamyl transferase levels (β: 0.333 (0.130–0.573); p = 0.002), and elevated alanine aminotransferase levels (β: 0.427 (0.224–0.629); p < 0.001) compared to HIV−. Use of second-line ART was positively associated with high-sensitivity C-reactive protein (p = 0.002). Although ECG parameters did not differ between HIV− and HIV+/ART+, viral load positively associated with p-wave duration (0.306 (0.018–0.594); p = 0.038), and longer HIV duration (≥5 years) with ST-interval (0.270 (0.003–0.537); p = 0.047) after adjusting for confounding factors. Our findings suggest that HIV and ART are associated with mixed effects on this population’s cardiometabolic profile and cardiac electrical activity, underpinning the importance of cardiovascular risk monitoring in PWH.

People living with HIV display increased anti-apolipoprotein A1 auto-antibodies, inflammation, and kynurenine metabolites: a case–control study

“…Urine samples were analysed to determine microalbuminuria (mg/L) and creatinine (mmol/L) using an enzymatic chemiluminescence method by cobas® 501/502 and cobas® 311/501 analysers (Roche/Hitachi cobas® c systems, Basel, Switzerland), respectively, and the albumin-to-creatinine ratio (ACR) (mg/mmol) was computed. In HIV+ participants, the levels of cluster of differentiation four (CD4)+ T-cell count and viral load (VL) were determined by flow cytometry (FC 500 MPL) with MXP software (Beckman Coulter, Brea, CA, USA) and the COBAS® AmpliPrep/COBAS® TaqMan® HIV-1 Test, v2.0 (Roche Diagnostics Ltd., Burgess Hill, UK), respectively ( 28 ).…”

Electrocardiographic abnormalities to the patients infected with HIV/AIDS under antiretroviral tritherapy at the University Clinics of Kinshasa

“…Electrocardiogram (ECG) abnormalities are more common to PLHIV with or without ART than to HIVnegative people, at the subclinical stage [2], with a prevalence of 57%, aggravated by the therapeutic combinations containing the asymptomatic protease inhibitors [4]. Unfortunately unrecognized for most cases, which progress to heart failure in these patients; and little study in the DRC.The electrocardiogram is an available tool, accessible to practitioners, for the screening of cardiac abnormalities at ART initiation and for monitoring these patients..…”

“…Cardiovascular complications are on the rise among people living with HIV/AIDS (PLHIV); However, the relationship between HIV and ART therapy-related parameters, cardiovascular risk (CVR), and cardiac electrical activity in PWH remains understudied, especially in sub-Saharan African (SSA) populations. [2].Cardiovascular complications have now become one of the leading causes of hospitalization among PLHIV treated with ART and of death in developed countries 6-15% [3].…”