Risk Factors of Cardiovascular Diseases in HIV/AIDS Patients on HAART

Abstract

Background : The introduction and widespread use of combination antiretroviral therapy referred to as highly active antiretroviral therapy (HAART) in the mid 1990’s, has led HIV-infected individuals to experience a dramatic decline in immunodeficiency-related events and death. There is growing concern on metabolic complications associated with HIV and HAART which may increase cardiovascular risk and disease. The aim of this study was to investigate the cardiovascular risk profile of HIV/AIDS patients receiving HAART and those not receiving HAART at HIV/AIDS treatment centres in the South West Region of Cameroon.Methods : Consenting participants, who had been receiving HAART, were compared with HAART naive participants. A questionnaire was administered; anthropometric and blood pressure measurements were recorded under standard conditions. Blood samples were obtained for the determination of plasma glucose and lipid levels.Results : Two hundred and fifteen participants were recruited, 160 (74.4%) were on HAART and 55 (25.6%) were HAART naive. Among the individual lipid abnormalities, increased total cholesterol was the most prevalent (40.0%). Participants on HAART were significantly about 8 times at risk of developing hypercholesterolemia when compared to the HAART inexperienced group (OR 8.17; 95% CI: 3.31-20.14; p<0.001). Hypertension had a prevalence of 25.6% (95% CI: 15.3%-35.9%) and was about 2 times significantly higher in the HAART treated than the HAART untreated group (p=0.033). The prevalence of low HDL-c was significantly higher in males (24.1%) compared to females (11.2%) (p=0.0196). Many females (27.3%) were obese compared to males (7.4%) (p=0.0043). HAART use and treatment duration of more than five years were significantly associated with higher prevalence of CVD risk factors.Conclusion : HAART treatment was associated with significantly higher prevalence of hypercholesterolemia, increased LDL-c and hypertension, hence the risk of cardiovascular diseases.

Incidence and prevalence of type 2 diabetes mellitus with HIV infection in Africa: a systematic review and meta-analysis

“…After screening, 20 articles met the eligibility criteria [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] and were included in the analysis (figure 1). Of these, seven 17-23 articles reported incidence of T2DM in HIV-infected participants, eight 24-31 reported prevalence of T2DM in HIV-infected participants compared with uninfected controls and five 32-36 reported prevalence of T2DM in HIV-infected participants on treatment compared with untreated controls.…”

“…Table 4 shows the data for five studies included in the meta-analysis comparing HIV treated (n=1120) with untreated participants (n=828). The majority of included participants were women (ranged from 58% 34 to 75% women 36 figure 5.…”

Beneficial and Detrimental Effects of Antiretroviral Therapy on HIV-Associated Immunosenescence

“…Indeed, an increase in oxidative stress has been frequently associated with antiretroviral treatment in HIV patients [128-130]. Several studies have demonstrated that the increase in ROS production mediated by HAART favours the onset of ageing-associated diseases [131-133]. Moreover, accumulation of somatic mutations in mtDNA and ROS in hematopoietic progenitors may account for the persistence of immune dysfunction observed after therapy withdrawal [8].…”

Enfermedad cardiovascular y metabólica en pacientes infectados por el virus de la inmunodeficiencia humana

“…En un estudio realizado por Mashinya y Colaboradores donde evaluaron los efectos adversos de la TAR, perfil lipídico, tabaquismo, obesidad, diabetes, carga viral y conteo de CD4, concluyeron que los factores de riesgo cardiovasculares fueron frecuentes en la población infectada con VIH en tratamiento y además una alta proporción de estos se encontraban en moderadoalto riesgo según la escala Framinghan 13,20 . Otro estudio realizado por Dickson y Colaboradores cuyo objetivo era investigar el perfil de riesgo cardiovascular de los pacientes VIH que recibían TARGA y de los que no la recibían, el resultado obtenido asoció el tratamiento de la TARGA con mayor prevalencia de hipercolesterolemia, aumento de colesterol LDL e hipertensión arterial 21 . coMproMIso cardIovascular en pacIentes con vIH…”