Risk of Cardiovascular Disease in an Aging HIV Population: Where Are We Now?

Martín-Iguacel, Raquel; Llibre, Josep M.; Friis-Møller, Nina

doi:10.1007/s11904-015-0284-6

Cited by 62 publications

(62 citation statements)

References 110 publications

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“…Furthermore, smoking cessation should be a cornerstone of primary CVD prevention, but is inadequately addressed in most HIV care settings in China. Further research is necessary to identify the prevention strategies that are most feasible and effective for reducing CVD risk within our population, and should combine both life-style modification strategies with pharmacologic management of hypertension, diabetes, and dyslipidemia [5, 14]. Although the currently existing CVD risk scores may not have been designed with our population in mind, they nevertheless provide a starting point for care providers to evaluate key CVD risk factors and identify individuals at highest-risk who may need close evaluation and management.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular disease risk among Chinese antiretroviral-naïve adults with advanced HIV disease

Guo

Hsieh

et al. 2017

BMC Infect Dis

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BackgroundCardiovascular disease (CVD) is an important cause of mortality among HIV-infected patients, however little is known about the burden of CVD among this population in Asia. We sought to quantify prevalence of CVD risk factors, 10-year CVD risk, and patterns of CVD risk factor treatment in a group of individuals with HIV in China.MethodsWe retrospectively analyzed baseline data from treatment-naïve HIV-infected adults enrolled in two multicenter clinical trials in China. Data regarding CVD risk factors such as smoking, hypertension, diabetes, dyslipidemia and obesity were assessed. The Framingham Risk Score (FRS) and Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) risk scores were calculated to estimate 10-year CVD risk. The American College of Cardiology/American Heart Association Atherosclerotic Cardiovascular Disease (ASCVD) Risk Score was used to identify individuals meeting criteria for lipid-lowering therapy.ResultsIn total, 973 patients were included in the analysis. Mean age was 36.0 ± 10.2 years and 74.2% were men. The most common CVD risk factors were dyslipidemia (51.7%) and smoking (23.7%). Prevalence of hypertension, diabetes and obesity were 8.4%, 4.6% and 1.0%, respectively. Over 65% of patients had at least one CVD risk factor. The prevalence of 10-year risk of CVD ≥10% was 4.5% based upon FRS and was 3.3% based upon D:A:D risk score. Few patients with dyslipidemia, hypertension or diabetes were on treatment.ConclusionsCVD risk factors are common but under-treated among Chinese treatment-naïve individuals with HIV. Future interventions should focus on training HIV providers to appropriately recognize and manage CVD risk factors during routine clinical assessments.

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Section: Discussionmentioning

confidence: 99%

Cardiovascular disease risk among Chinese antiretroviral-naïve adults with advanced HIV disease

Guo

Hsieh

et al. 2017

BMC Infect Dis

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“…Grandes estudios observacionales de cohorte demostraron consistentemente mayores tasas de ECV, incluyendo IAM entre los infectados con VIH en comparación con los controles no infectados, con un aproximado de 1,5 a 2 veces mayor riesgo relativo en la última década [36][37][38][39][40][41] . Datos recientes han reforzado estos hallazgos, por ejemplo en un estudio de más de 27 000 pacientes infectados con VIH, las tasas de IAM fueron mayores para pacientes VIH en todos los grupos etarios en comparación con los pacientes control emparejados 39 .…”

Section: Enfermedad Arterial Coronaria E Infarto De Miocardiounclassified

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

Camargo-Ariza

Galvis-Blanco

Gualdrón-Rincón

et al. 2017

revmed

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“…Nel soggetto HIV+ la formazione di placche aterosclerotiche instabili sembra avvenire in un'età più precoce. Nei paesi occidentali circa il 20% delle morti in soggetti HIV /AIDS sono attribuibili a malattie cardiovascolari (26). Recenti studi hanno evidenziato che l'infezione da HIV possa essere associata a fibrosi interstiziale miocardica e aumento del grasso cardiaco con disfunzione ventricolare (25).…”

Section: Conseguenze Clinicheunclassified

Invecchiamento cellulare e infezione da HIV

Dentone¹,

Fenoglio²

2016

JHA

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RiassuntoCon la maggiore disponibilità della terapia antiretrovirale, la popolazione HIV positiva del mondo sta invecchiando. I pazienti trattati con successo sembra possano raggiungere una longevità che si avvicina a quella della popolazione generale. Sebbene l'aspettativa di vita dei soggetti HIV positivi stia aumentando sempre di più, è controverso se il virus stesso dell'HIV acceleri il processo di invecchiamento. L'infiammazione cronica persistente e l'immuno-attivazione osservate tipicamente nella popolazione anziana possono essere ritrovate nei pazienti HIV positivi con un processo di invecchiamento prematuro. Questi aspetti sono correlati all'immuno-senescenza che determina un danno immunologico funzionale ed una ridotta abilità adattativa allo stress metabolico. Anche se i pazienti HIV positivi con la terapia antiretrovirale raggiungono la viremia non rilevabile e un'elevata conta di TCD4+, valori elevati di infiammazione in questi soggetti sono associati alle più importanti complicanze non AIDS-correlate dell'infezione cronica da HIV. Lo scopo di questa review è l'analisi del processo dinamico del rimodellamento immunitario, conosciuto come immuno-senescenza, che avviene nella storia del paziente con infezione da HIV e della sua influenza sulle comorbità a lungo termine. Abstract With the wider availability of antiretroviral therapy, HIV positive population is aging worldwide. Successfully treated individuals could achieve a longevity approaching that of the general population. Although the life expectancy of HIV positive people has increased dramatically, whether HIV itself accelerates the aging process is still controversial. A persistent chronic inflammation and immune activation, typically observed in elderly people, can be present in HIV infected patients who experience a type of premature aging. These aspects are linked to the immune senescence that results in functional impairments of immunity and in reduced ability to adapt to metabolic stress. Even if the HIV positive patients on antiretroviral therapy reach an undetectable viral load and a high CD4 cells count, elevated rates of inflammation in these population are associated with the most important non-AIDS related complication of chronic HIV infection. The purpose of this review is to focus on the dynamic process of immune remodelling, known as immune senescence, which occurs during HIV infection, and how it affects long-term comorbidities.Introduzione L'introduzione della terapia antiretrovirale altamente efficace (HAART) ha migliorato significativamente gli aspetti immunologici e virologici del paziente HIV positivo (HIV+), modificandone anche lo stato patologico e la mortalità (1). Recenti dati riguardanti la mortalità dei soggetti HIV positivi indicano che pazienti con conta dei linfociti T CD4+ superiore a 350 cellule/mmc e soppressione virologica, in assenza di altri fattori di rischio, presentano un'aspettativa di vita simile a quella della popolazione generale (2). In Europa e negli Stati Uniti è aumentata notevolmente la proporzion...

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Risk of Cardiovascular Disease in an Aging HIV Population: Where Are We Now?

Cited by 62 publications

References 110 publications

Cardiovascular disease risk among Chinese antiretroviral-naïve adults with advanced HIV disease

Cardiovascular disease risk among Chinese antiretroviral-naïve adults with advanced HIV disease

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

Invecchiamento cellulare e infezione da HIV

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