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Cardiovascular disease risk in an urban African population: a cross-sectional analysis on the role of HIV and antiretroviral treatment.
Retrovirology 2019; 16(1):37R

Abstract

BACKGROUND

Life expectancy is increasing in the HIV-positive population and age-related non-communicable diseases, such as cardiovascular disease, (CVD) are seen more frequently. This study investigated to what extent HIV and antiretroviral therapy (ART) is associated with CVD risk in an urban African population.

METHODS

A cross-sectional study was performed in Johannesburg, South Africa, between July 2016 and November 2017. Both HIV-positive adults (ART-naïve, or on first- or second-line ART), as well as age and sex matched HIV-negative controls who were family or friends of the HIV-positive participants were included. Data were collected on demographics, cardiovascular risk factors, HIV-related characteristics, carotid intima-media thickness (CIMT) and carotid distensibility. The association between HIV, ART and CIMT and distensibility was analysed with linear regression models, adjusting for age, gender and CVD risk factors.

RESULTS

The study included 548 participants, 337 (62%) females, age 38.3 ± 9.5 years of whom 104 (19.0%) were HIV-positive, ART-naïve; 94 (17.2%) were on first-line ART; 197 (35.9%) were on second-line ART; and 153 (27.9%) were HIV-negative. Participants on second-line ART had higher CIMT and lower distensibility compared to the other groups (p < 0.001). After adjustment for age, these outcomes were similar between groups. Further adjustment for CVD and HIV-related factors did not alter the findings.

CONCLUSION

Neither HIV nor ART was associated with CIMT or carotid distensibility in this urban African population. Longitudinal studies are needed to fully understand the relationship between HIV and CVD across different populations.

Authors+Show Affiliations

Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands. a.g.vos-8@umcutrecht.nl. Department of Internal Medicine & Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands. a.g.vos-8@umcutrecht.nl. Ezintsha, Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa. a.g.vos-8@umcutrecht.nl.Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands.Department of Internal Medicine & Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands.Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.Ezintsha, Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.Department of Chemical Pathology, National Health Laboratory Service and University of the Witwatersrand, Johannesburg, South Africa.Ezintsha, Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands.Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands.Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands. Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31796103

Citation

Vos, Alinda G., et al. "Cardiovascular Disease Risk in an Urban African Population: a Cross-sectional Analysis On the Role of HIV and Antiretroviral Treatment." Retrovirology, vol. 16, no. 1, 2019, p. 37.
Vos AG, Hoeve K, Barth RE, et al. Cardiovascular disease risk in an urban African population: a cross-sectional analysis on the role of HIV and antiretroviral treatment. Retrovirology. 2019;16(1):37.
Vos, A. G., Hoeve, K., Barth, R. E., Peper, J., Moorhouse, M., Crowther, N. J., ... Klipstein-Grobusch, K. (2019). Cardiovascular disease risk in an urban African population: a cross-sectional analysis on the role of HIV and antiretroviral treatment. Retrovirology, 16(1), p. 37. doi:10.1186/s12977-019-0497-7.
Vos AG, et al. Cardiovascular Disease Risk in an Urban African Population: a Cross-sectional Analysis On the Role of HIV and Antiretroviral Treatment. Retrovirology. 2019 12 3;16(1):37. PubMed PMID: 31796103.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiovascular disease risk in an urban African population: a cross-sectional analysis on the role of HIV and antiretroviral treatment. AU - Vos,Alinda G, AU - Hoeve,Klariska, AU - Barth,Roos E, AU - Peper,Joyce, AU - Moorhouse,Michelle, AU - Crowther,Nigel J, AU - Venter,Willem D F, AU - Grobbee,Diederick E, AU - Bots,Michiel L, AU - Klipstein-Grobusch,Kerstin, Y1 - 2019/12/03/ PY - 2019/08/10/received PY - 2019/11/22/accepted PY - 2019/12/5/entrez PY - 2019/12/5/pubmed PY - 2019/12/5/medline KW - Antiretroviral therapy KW - Cardiovascular disease KW - Carotid distensibility KW - Carotid intima-media thickness KW - Human immunodeficiency virus KW - Sub-Saharan Africa SP - 37 EP - 37 JF - Retrovirology JO - Retrovirology VL - 16 IS - 1 N2 - BACKGROUND: Life expectancy is increasing in the HIV-positive population and age-related non-communicable diseases, such as cardiovascular disease, (CVD) are seen more frequently. This study investigated to what extent HIV and antiretroviral therapy (ART) is associated with CVD risk in an urban African population. METHODS: A cross-sectional study was performed in Johannesburg, South Africa, between July 2016 and November 2017. Both HIV-positive adults (ART-naïve, or on first- or second-line ART), as well as age and sex matched HIV-negative controls who were family or friends of the HIV-positive participants were included. Data were collected on demographics, cardiovascular risk factors, HIV-related characteristics, carotid intima-media thickness (CIMT) and carotid distensibility. The association between HIV, ART and CIMT and distensibility was analysed with linear regression models, adjusting for age, gender and CVD risk factors. RESULTS: The study included 548 participants, 337 (62%) females, age 38.3 ± 9.5 years of whom 104 (19.0%) were HIV-positive, ART-naïve; 94 (17.2%) were on first-line ART; 197 (35.9%) were on second-line ART; and 153 (27.9%) were HIV-negative. Participants on second-line ART had higher CIMT and lower distensibility compared to the other groups (p < 0.001). After adjustment for age, these outcomes were similar between groups. Further adjustment for CVD and HIV-related factors did not alter the findings. CONCLUSION: Neither HIV nor ART was associated with CIMT or carotid distensibility in this urban African population. Longitudinal studies are needed to fully understand the relationship between HIV and CVD across different populations. SN - 1742-4690 UR - https://www.unboundmedicine.com/medline/citation/31796103/Cardiovascular_disease_risk_in_an_urban_African_population:_a_cross-sectional_analysis_on_the_role_of_HIV_and_antiretroviral_treatment L2 - https://retrovirology.biomedcentral.com/articles/10.1186/s12977-019-0497-7 DB - PRIME DP - Unbound Medicine ER -