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HIV and cardiovascular disease

Pamela Fergusson, Nicole Greenspan, Lukas Maitland, Rémy Huberdeau
Transgender people are an important group for whom access to healthcare is often problematic. Dietitians need to be aware of key issues in transgender health to provide culturally competent clinical nutritional care. This article serves as a primer, clarifying key terms and concepts, exploring the impact of stigma and discrimination on health and nutrition for people from transgender communities, and offering practical advice for nutritional and other related issues. Education for dietitians both pre- and postqualification is an important part of improving care and building skills and awareness of cultural humility...
March 15, 2018: Canadian Journal of Dietetic Practice and Research
Joshua A Beckman, Meredith S Duncan, Charles W Alcorn, Kaku So-Armah, Adeel A Butt, Matthew B Goetz, Hilary A Tindle, Jason Sico, Russel P Tracy, Amy C Justice, Matthew S Freiberg
Background -The effect of HIV on the development of peripheral artery disease (PAD) remains unclear. We investigated whether HIV infection is associated with an increased risk of PAD after adjustment for traditional atherosclerotic risk factors in a large cohort of HIV infected (HIV+) and demographically similar HIV uninfected veterans. Methods -We studied participants in the Veterans Aging Cohort Study from April 1, 2003 through December 31, 2014. We excluded participants with known prior PAD or prevalent cardiovascular disease (myocardial infarction, stroke, coronary heart disease, and congestive heart failure) and analyzed the effect of HIV status on the risk of incident PAD events after adjusting for demographics, PAD risk factors, substance use, CD4 cell count, HIV-1 RNA, and antiretroviral therapy...
March 13, 2018: Circulation
Theodoros Kelesidis, Carlee B Moser, Elizabeth Johnston, James H Stein, Michael P Dube, Otto O Yang, Grace A McComsey, Judith S Currier, Todd T Brown
BACKGROUND: The contributions of the Receptor activator of nuclear factor kappa-B ligand (RANKL)/osteoprotegerin (OPG) axis to cardiovascular and bone disease in treated HIV-1 infection is not well-defined. SETTING: Prospective, observational, longitudinal study. METHODS: In a subset analysis of a prospective randomized clinical trial, 234 HIV-1-infected antiretroviral therapy (ART)-naïve participants received tenofovir-emtricitabine plus either atazanavir/ritonavir, darunavir/ritonavir, or raltegravir and achieved plasma HIV-1 RNA <50 copies/ml by week 24 and thereafter...
March 12, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Fuu-Jen Tsai, Te-Mao Li, Chi-Fung Cheng, Yang-Chang Wu, Chih-Ho Lai, Tsung-Jung Ho, Xiang Liu, Hsinyi Tsang, Ting-Hsu Lin, Chiu-Chu Liao, Shao-Mei Huang, Ju-Pi Li, Jung-Chun Lin, Chih-Chien Lin, Wen-Miin Liang, Ying-Ju Lin
ETHNOPHARMACOLOGICAL RELEVANCE: Due to the development of antiretroviral therapy (ART), HIV/AIDS is now regarded as a treatable chronic disease. Chinese herbal medicine (CHM) is a type of complementary and alternative medicine (CAM) that has been widely applied in the healthcare system in Taiwan. AIM OF THE STUDY: The aim of this study was to investigate the frequency of use and patterns of prescription for the CHM-based treatment of HIV-infected patients and to assess the long-term effects of CHM on hyperlipidemia and cardiovascular disease events in these patients...
March 9, 2018: Journal of Ethnopharmacology
Jane Goudge, Tobias Chirwa, Sandra Eldridge, Francesc Xavier F Gómez-Olivé, Chodziwadziwa Kabudula, Felix Limbani, Eustasius Musenge, Margaret Thorogood
Introduction: In low/middle-income countries with substantial HIV and tuberculosis epidemics, health services often neglect other highly prevalent chronic conditions, such as hypertension, which as a result are poorly managed. This paper reports on a study to assess the effect on hypertension management of lay health workers (LHW) working in South African rural primary healthcare clinics to support the provision of integrated chronic care. Methods: A pragmatic cluster randomised trial with a process evaluation in eight rural clinics assessed the effect of adding two LHWs supporting nurses in providing chronic disease care in each intervention clinic over 18 months...
2018: BMJ Global Health
Nidaa Mikail, Mathieu Sinigaglia, Fabien Hyafil
Important progresses in the management of patients with human immunodeficiency virus, in particular the advent of new anti-retroviral therapies (ART), have turned this rapidly fatal condition into a controllable chronic disease with a life expectancy that approaches the one from the general population. Cardiovascular diseases have now become one of the leading causes of non-HIV-related mortality in this population. Several factors including the presence of HIV in the vascular wall and the development of dyslipidemia and alteration in body fat distribution under ART might play a role the progression of atherosclerosis in HIV-infected patients...
March 8, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Derek J Chan, Virginia Furner, Don E Smith, Mithilesh Dronavalli, Rohan I Bopage, Jeffrey J Post, Anjali K Bhardwaj
OBJECTIVE: To assess the prevalence of non-AIDS co-morbidities (NACs) and predictors of adverse health outcomes amongst people living with HIV in order to identify health needs and potential gaps in patient management. DESIGN: Retrospective, non-consecutive medical record audit of patients attending a publicly funded HIV clinic in metropolitan Sydney analysed for predictors of adverse health outcomes. We developed a scoring system based on the validated Charlson score method for NACs, mental health and social issues and confounders were selected using directed acyclic graph theory under the principles of causal inference...
March 8, 2018: AIDS Research and Therapy
Oluwatosin Olaiya, John Weiser, Wen Zhou, Pragna Patel, Heather Bradley
Hypertension is a leading modifiable risk factor for cardiovascular disease (CVD), and persons living with HIV are at increased risk for both hypertension and CVD. Therefore, using data from a nationally representative sample of patients living with HIV, we assessed missed opportunities for the optimal management of hypertension.
March 2018: Open Forum Infectious Diseases
Camilla I Hatleberg, Lene Ryom, Wafaa El-Sadr, Amanda Mocroft, Peter Reiss, Stephane De Wit, Francois Dabis, Christian Pradier, Antonella d'Arminio Monforte, Helen Kovari, Matthew Law, Jens D Lundgren, Caroline A Sabin
INTRODUCTION: There is paucity of data related to potential gender differences in the use of interventions to prevent and treat cardiovascular disease (CVD) among HIV-positive individuals. We investigated whether such differences exist in the observational D:A:D cohort study. METHODS: Participants were followed from study enrolment until the earliest of death, six months after last visit or February 1, 2015. Initiation of CVD interventions [lipid-lowering drugs (LLDs), angiotensin-converting enzyme inhibitors (ACEIs), anti-hypertensives, invasive cardiovascular procedures (ICPs) were investigated and Poisson regression models calculated whether rates were lower among women than men, adjusting for potential confounders...
March 2018: Journal of the International AIDS Society
Eileen P Scully
PURPOSE OF REVIEW: This review will outline the multilevel effects of biological sex on HIV acquisition, pathogenesis, treatment response, and prospects for cure. Potential mechanisms will be discussed along with future research directions. RECENT FINDINGS: HIV acquisition risk is modified by sex hormones and the vaginal microbiome, with the latter acting through both inflammation and local metabolism of pre-exposure prophylaxis drugs. Female sex associates with enhanced risk for non-AIDS morbidities including cardiovascular and cerebrovascular disease, suggesting different inflammatory profiles in men and women...
March 5, 2018: Current HIV/AIDS Reports
Carmen Fontela, Jesús Castilla, Regina Juanbeltz, Iván Martínez-Baz, María Rivero, Aisling O'Leary, Natalia Larrea, Ramón San Miguel
OBJECTIVES: The increased survival of HIV-infected individuals has resulted in a premature aging of this population, with the consequent development of premature age-related comorbidities and risk factors. We aimed to describe the prevalence of age-related comorbidities and cardiovascular risk factors in older adults with HIV infection on antiretroviral therapy (ART). METHODS: A retrospective cross-sectional study was undertaken in a cohort of HIV patients aged ≥50 years on ART in September 2016 in Spain...
February 28, 2018: Postgraduate Medicine
Derrick Ssewanyana, Amina Abubakar, Anneloes van Baar, Patrick N Mwangala, Charles R Newton
Unhealthy diet and physical inactivity are among the key modifiable risk factors for non-communicable diseases, such as diabetes and cardiovascular disease. Although such diseases often only appear in adulthood, these behaviors are typically initiated or reinforced already during adolescence. However, knowledge on underlying factors for adolescents' unhealthy dieting and physical inactivity in sub-Saharan Africa (SSA) is poor. We conducted in-depth interviews and focus group discussions to explore the perceptions of a diverse group of 78 young people of 10-19 years of age, which also included some adolescents living with HIV, as this is an emerging group in the HIV/AIDS epidemic in many parts of SSA...
2018: Frontiers in Public Health
Tanvi S Sharma, Gabriel Somarriba, Kristopher L Arheart, Daniela Neri, M Sunil Mathew, Patricia L Graham, Gwendolyn B Scott, Tracie L Miller
BACKGROUND: Combination antiretroviral therapy (cART) has allowed youth with perinatal HIV infection (PHIV+) to live into adulthood, but many youth may experience metabolic and body composition changes that predispose to greater cardiovascular disease (CVD) risk. This longitudinal study evaluated changes in body composition measured by dual x-ray absorptiometry (DXA) in a cohort of PHIV+ youth compared to HIV- controls over a 7-year period. METHODS: PHIV+ youth and HIV- controls were prospectively enrolled in a single-site study to assess nutrition and CVD risk...
February 22, 2018: Pediatric Infectious Disease Journal
Marco Gelpi, Shoaib Afzal, Jens Lundgren, Andreas Ronit, Ashley Roen, Amanda Mocroft, Jan Gerstoft, Anne-Mette Lebech, Birgitte Lindegaard, Klaus Fuglsang Kofoed, Børge G Nordestgaard, Susanne Dam Nielsen
Background: People living with HIV (PLWH) have lower life expectancy than uninfected individuals, partly explained by excess risk of cardiovascular diseases (CVD) and CVD risk factors. We investigated the association between HIV infection and abdominal obesity, elevated LDL cholesterol (LDL-C), hypertriglyceridemia and hypertension, in a large cohort of predominantly well-treated PLWH and matched controls. Methods: 1,099 PLWH from the Copenhagen Co-morbidity in HIV infection (COCOMO) study and 12,161 age and sex-matched uninfected controls from the Copenhagen General Population Study were included and underwent blood pressure, waist-, hip-, weight-, and height-measurements...
February 17, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Barbara Castelnuovo, Frank Mubiru, Agnes N Kiragga, Rachel Musomba, Olive Mbabazi, Paul Gonza, Andrew Kambugu, Rosalind Parks Ratanshi
PURPOSE: Little information is available on patients on antiretroviral treatment (ART) after a long-term period from sub-Saharan Africa, with the longest follow-up and related outcomes being after 10 years on ART. At the Infectious Diseases Institute (IDI) (Kampala, Uganda), we set up a cohort of patients already on ART for 10 years at the time of enrolment, who will be followed up for additional 10 years. PARTICIPANTS: A prospective observational cohort of 1000 adult patients previously on ART for 10 years was enrolled between May 2014 and September 2015...
February 21, 2018: BMJ Open
Sudeep P Pushpakom, Antonysunil Adaikalakoteswari, Andrew Owen, David J Back, Gyanendra Tripathi, Sudhesh Kumar, Philip McTernan, Munir Pirmohamed
BACKGROUND: Antiretroviral therapy in HIV-positive patients leads to insulin resistance which is central to the pathogenesis of various metabolic abnormalities and cardiovascular disease seen in this patient group. We have investigated the dose-response relationship of telmisartan, an antihypertensive, on adipocytes in vitro in order to determine whether it may have metabolic beneficial effects. METHODS: Using in vitro chronic toxicity models (3T3-F442A murine and primary human adipocytes), we evaluated the effects of different concentrations of telmisartan on adipocyte differentiation and adipogenic gene expression using lipid accumulation assays and real-time polymerase chain reaction, respectively...
February 1, 2018: Diabetes & Vascular Disease Research
Kerry A McBrien, Noah Ivers, Lianne Barnieh, Jacob J Bailey, Diane L Lorenzetti, David Nicholas, Marcello Tonelli, Brenda Hemmelgarn, Richard Lewanczuk, Alun Edwards, Ted Braun, Braden Manns
BACKGROUND: People with chronic diseases experience barriers to managing their diseases and accessing available health services. Patient navigator programs are increasingly being used to help people with chronic diseases navigate and access health services. OBJECTIVE: The objective of this review was to summarize the evidence for patient navigator programs in people with a broad range of chronic diseases, compared to usual care. METHODS: We searched MEDLINE, EMBASE, CENTRAL, CINAHL, PsycINFO, and Social Work Abstracts from inception to August 23, 2017...
2018: PloS One
Nadia Galizzi, Laura Galli, Andrea Poli, Nicola Gianotti, Elisabetta Carini, Alba Bigoloni, Giuseppe Tambussi, Silvia Nozza, Adriano Lazzarin, Antonella Castagna, Daniela Mancusi, Roberta Termini
INTRODUCTION: A regimen with rilpivirine (RPV), abacavir (ABC) and lamivudine (3TC) is simple and may allow the sparing of tenofovir and protease inhibitors. However, data on use of this combination as a strategy of switch are limited. Aims of the study were to assess the long-term efficacy and safety of this regimen. METHODS: Retrospective study on HIV-1 infected patients followed at the Infectious Disease Department of the San Raffaele Scientific Institute, HBsAg-negative, HLA B5701-negative, with no documented resistance to RPV, ABC and 3TC, with HIV-RNA<50 copies/mL who started RPV plus ABC/3TC from March 2013 to September 2015...
2018: PloS One
Virginia A Triant, Jeremiah Perez, Susan Regan, Joseph M Massaro, James B Meigs, Steven K Grinspoon, Ralph B D'Agostino
Background -Cardiovascular disease (CVD) risk is elevated in HIV-infected individuals, with contributions from both traditional and non-traditional risk factors. The accuracy of established CVD risk prediction functions in HIV is uncertain. We sought to assess the performance of three established CVD risk prediction functions in a longitudinal cohort of HIV-infected men. Methods -Framingham Heart Study (Framingham) functions for hard coronary heart disease (Framingham CHD) and atherosclerotic CVD (Framingham ASCVD) and the American College of Cardiology/American Heart Association (ACC/AHA ASCVD) function were applied to the Partners HIV cohort...
February 14, 2018: Circulation
Padraig McGettrick, Elena Alvarez Barco, Patrick W G Mallon
The population of people living with HIV (PLWH) is growing older with an estimated 4 million over the age of 50 years, a figure which has doubled since the introduction of effective antiretroviral therapy (ART) and which is increasing globally. Despite effective ART, PLWH still experience excess morbidity and mortality compared to the general population with increased prevalence of age-related, non-AIDS illnesses (NAI) such as cardiovascular disease, malignancies, cognitive impairment and reduced bone mineral density, which impact disability and everyday functioning...
February 14, 2018: Healthcare (Basel, Switzerland)
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