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HIV statin cardiovascular

V Pascual Fuster
Dyslipaemia is one of the main risk factors in the development of cardiovascular diseases. Currently, there are different alternatives available (amongst which statins occupy a pre-eminent place), to optimise the treatment of patients at high or very high cardiovascular risk. Despite this, the percentage of patients that achieve good lipid control is low. The causes of the mismatch with proposed objectives include lack of patient adherence and therapeutic inertia. This review uses available evidence and the latest clinical guides as a basis to assess the pharmacological treatment of dyslipaemia in patients with a background of arteriosclerotic vascular disease, diabetes, chronic kidney disease, cardiovascular risk at ≥5% calculated by SCORE and familial hypercholesterolaemia...
December 2016: Revista Española de Sanidad Penitenciaria
Ann J Melvin, Grace Montepiedra, Lisa Aaron, William A Meyer, Hans M Spiegel, William Borkowsky, Mark J Abzug, Brookie M Best, Marilyn J Crain, Peggy R Borum, Bobbie Graham, Patricia Anthony, Katherine Shin, George K Siberry
BACKGROUND: HIV-infected children receiving antiretroviral therapy (ART) have increased prevalence of hyperlipidemia and risk factors for cardiovascular disease. No studies have investigated the efficacy and safety of statins in this population. METHODS: HIV-infected youth aged 10 - < 24 years on stable ART with low-density lipoprotein-cholesterol (LDL-C) ≥130 mg/dL for ≥ 6 months initiated atorvastatin 10mg once daily. Atorvastatin was increased to 20mg if LDL-C efficacy criteria (LDL-C < 110 mg/dL or decreased ≥30% from baseline) were not met at week 4...
October 3, 2016: Pediatric Infectious Disease Journal
Nina E Diana, Saraladevi Naicker
The prevalence of HIV-associated chronic kidney disease (CKD) varies geographically and depends on the definition of CKD used, ranging from 4.7% to 38% globally. The incidence, however, has decreased with the use of effective combined antiretroviral therapy (cART). A wide variety of histological patterns are seen in HIV-associated kidney diseases that include glomerular and tubulointerstitial pathology. In resource-rich settings, there has been a plateau in the incidence of end-stage renal disease secondary to HIV-associated nephropathy (HIVAN)...
2016: International Journal of Nephrology and Renovascular Disease
Nyarai D Soko, Collen Masimirembwa, Collet Dandara
The incidence of cardiovascular diseases (CVDs) in African populations residing in the African continent is on the rise fueled by both a steady increase in CVD risk factors and comorbidities such as human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), tuberculosis, and parasitic diseases such as bilharzia. Statins are recommended together with lifestyle changes in the treatment of hypercholesterolemia and overall reduction of cardiovascular events. Rosuvastatin in particular is an attractive candidate in the management of CVDs in African populations often plagued with multimorbidities owing to both its potency and low drug-to-drug interaction potential...
September 2016: Omics: a Journal of Integrative Biology
Allison Ross Eckard, Eric G Meissner, Inderjit Singh, Grace A McComsey
Human immunodeficiency virus (HIV)-infected patients are at an increased risk of serious, non-AIDS-defining comorbidities, even in the setting of viral suppression with combination antiretroviral therapy. This increased risk is due in part to immune dysfunction and heightened inflammation and immune activation associated with chronic HIV infection. Statins have wide-reaching immunomodulatory effects, and their use in the HIV-infected population may be of particular benefit. In this article, we review the pathogenesis of increased inflammation during HIV infection and how it contributes to the risk of cardiovascular disease among HIV-infected individuals...
October 1, 2016: Journal of Infectious Diseases
Yamnia I Cortés, Nancy Reame, Cosmina Zeana, Haomiao Jia, David C Ferris, Elizabeth Shane, Michael T Yin
OBJECTIVE: To characterize and compare cardiovascular disease (CVD) risk in HIV-infected and uninfected postmenopausal minority women using the Framingham Risk Score (FRS) as an assessment measure. METHODS: A cross-sectional analysis was performed in 152 (109 HIV+, 43 HIV-) subjects from an existing study cohort of postmenopausal Hispanic and African American women. Data necessary to calculate FRS and menopause features were retrieved by retrospective chart review...
September 9, 2016: Journal of Women's Health
Nicholas T Funderburg, Morgan Boucher, Abdus Sattar, Manjusha Kulkarni, Danielle Labbato, Bruce I Kinley, Grace A McComsey
INTRODUCTION: Altered gastrointestinal (GI) barrier integrity and subsequent microbial translocation may contribute to immune activation in HIV infection. We have reported that rosuvastatin improved several markers of immune activation in HIV+ participants, but the effect of statin treatment on markers of GI barrier dysfunction is unknown. METHODS: SATURN-HIV is a randomized, double-blind, placebo-controlled trial assessing the effect of rosuvastatin (10mg/daily) on markers of cardiovascular disease, inflammation, and immune activation in ART-treated patients...
2016: Pathogens & Immunity
Engelbert Bain Luchuo, Clovis Nkoke
Stroke and human immunodeficiency virus (HIV) infection are major causes of morbidity and mortality in Sub-Saharan Africa (SSA), with disease burdens being amongst the highest worldwide. HIV infection has emerged as an important risk factor for stroke. The remarkable development in the treatment of HIV infection which occurred in recent decades has allowed the survival of a large number of patients. This therapeutic success which allows patients to live longer has facilitated the emergence of a new population of adults with increased risk for cardiovascular disease including stroke due to aging, the direct effects of HIV infection and combined anti-retroviral therapy (cART)...
June 2016: Annals of Translational Medicine
James H Stein
Current guidelines for managing cholesterol to reduce cardiovascular disease (CVD) risk focus on providing the appropriate intensity of statin therapy to reduce low-density lipoprotein cholesterol (LDL-C) level. There is very little evidence supporting the use of treatments aimed at raising high-density lipoprotein cholesterol level or reducing triglyceride levels. HIV-infected persons have excess risk of CVD compared with the general population. Statins are less effective at reducing LDL-C levels in HIV-infected persons who are also at greater risk for adverse effects from statin treatment...
December 2016: Topics in Antiviral Medicine
Nicholas T Funderburg, Nehal N Mehta
Infection with the human immunodeficiency virus (HIV), and subsequent treatment with antiretroviral therapy (ART), is often associated with perturbations in lipid profiles. Furthermore, persistent inflammation, in spite of suppression of viral replication by ART, likely contributes to modifications in lipid composition and function, exacerbating risk for development of cardiovascular disease (CVD). Increased levels of several pro-inflammatory lipid species, including oxidized low-density lipoprotein (LDL) and high-density lipoprotein (HDL), have been measured in HIV-infected persons and are associated with markers of immune activation...
August 2016: Current HIV/AIDS Reports
Sadeer G Al-Kindi, Chantal ElAmm, Mahazarin Ginwalla, Emile Mehanna, Michael Zacharias, Rodolfo Benatti, Guilherme H Oliveira, Chris T Longenecker
BACKGROUND: Persons living with HIV are at a higher risk of cardiovascular disease despite effective antiretroviral therapy and dramatic reductions in AIDS-related conditions. We sought to identify the epidemiology of heart failure (HF) among persons living with HIV in the United States in an era of contemporary antiretroviral therapy. METHODS: Explorys is an electronic healthcare database that aggregates medical records from 23 healthcare systems nationwide. Using systemized nomenclature of medicine-clinical terms (SNOMED-CT), we identified adult patients (age>18), who had active records over the past year (September 2014-September 2015)...
September 1, 2016: International Journal of Cardiology
Chris T Longenecker, Abdus Sattar, Robert Gilkeson, Grace A McComsey
OBJECTIVE: To determine the effect of statins on the progression of subclinical atherosclerosis in a population of HIV-infected adults on antiretroviral therapy. DESIGN: Double-blind, randomized clinical trial. METHODS: Stopping Atherosclerosis and Treating Unhealthy Bone with RosuvastatiN in HIV infection was a 96-week double-blind, randomized clinical trial of 10 mg daily rosuvastatin (n = 72) vs. placebo (n = 75) in a population of HIV-infected subjects on stable antiretroviral therapy with LDL-cholesterol 130 mg/dl or less (≤3...
September 10, 2016: AIDS
Karuna Lamarca, Ana García Sarasola, Francesc Vidal, Pere Domingo
INTRODUCTION: Human immunodeficiency virus (HIV) has become a chronic disease often associated with dyslipidaemia and insulin resistance. Combination antiretroviral therapy (cART) may contribute to metabolic disturbances, eventually leading to increased cardiovascular disease (CVR) in this population. Escalating interventions to decrease CVR include promoting a healthy lifestyle, such as quitting smoking, diet and regular exercise. If they do not achieve the goals, a change of cART should be considered, followed by or used concomitantly with the use of chemical therapies...
July 2016: Expert Opinion on Pharmacotherapy
Meredith E Clement, Lawrence P Park, Ann Marie Navar, Nwora Lance Okeke, Michael J Pencina, Pamela S Douglas, Susanna Naggie
BACKGROUND: Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections are associated with increased risk of cardiovascular disease (CVD). The potential impact of recently updated cholesterol guidelines on treatment of HIV- and HCV-infected veterans is unknown. METHODS: We performed a retrospective cohort study to assess statin use and recommendations among 13 579 HIV-infected, 169 767 HCV-infected, and 6628 HIV/HCV-coinfected male veterans aged 40-75 years...
August 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Payal Kohli, Peter Ganz, Yifei Ma, Rebecca Scherzer, Sophia Hur, Bernard Weigel, Carl Grunfeld, Steven Deeks, Scott Wasserman, Rob Scott, Priscilla Y Hsue
BACKGROUND: Proprotein convertase subtilisin kexin 9 (PCSK9) inhibitors reduce low-density lipoprotein cholesterol (LDL-C) and improve outcomes in the general population. HIV-infected individuals are at increased risk for cardiovascular events and have high rates of dyslipidemia and hepatitis C virus (HCV) coinfection, making PCSK9 inhibition a potentially attractive therapy. METHODS AND RESULTS: We studied 567 participants from a clinic-based cohort to compare PCSK9 levels in patients with HIV/HCV coinfection (n=110) with those with HIV infection alone (n=385) and with uninfected controls (n=72)...
May 2016: Journal of the American Heart Association
Justin R Kingery, Yona Alfred, Luke R Smart, Emily Nash, Jim Todd, Mostafa R Naguib, Jennifer A Downs, Samuel Kalluvya, Johannes B Kataraihya, Robert N Peck
OBJECTIVE: To compare short-term and long-term cardiovascular disease (CVD) risk scores and prevalence of metabolic syndrome in HIV-infected adults receiving and not receiving antiretroviral therapy (ART) to HIV-negative controls. METHODS: A cross-sectional study including 151 HIV-infected, ART-naive, 150 HIV-infected on ART and 153 HIV-negative adults. Traditional cardiovascular risk factors were determined by standard investigations. The primary outcome was American College of Cardiology/American Heart Association Atherosclerotic CVD (ASCVD) Risk Estimator lifetime CVD risk score...
August 1, 2016: Heart: Official Journal of the British Cardiac Society
Giuseppe Vittorio De Socio, Elena Ricci, Giustino Parruti, Leonardo Calza, Paolo Maggi, Benedetto Maurizio Celesia, Giancarlo Orofino, Giordano Madeddu, Canio Martinelli, Barbara Menzaghi, Lucia Taramasso, Giovanni Penco, Laura Carenzi, Marco Franzetti, Paolo Bonfanti
OBJECTIVES: To investigate the use of statins and acetylsalicylic acid (ASA) in HIV people in clinical practice. DESIGN: A multicenter, nationwide, prospective cohort study, including 1182 consecutive HIV patients was conducted. METHODS: Statin and ASA prescription was evaluated in primary and secondary cardiovascular disease prevention, according to the European AIDS Clinical Society (EACS) guidelines. RESULTS: Followed-up patients (998) were mostly males (70...
October 2016: Infection
Denise C Hsu, Irini Sereti
In the antiretroviral therapy (ART) era, serious non-AIDS events (SNAEs) have become the major causes of morbidity and mortality in HIV-infected persons. Early ART initiation has the strongest evidence for reducing SNAEs and mortality. Biomarkers of immune activation, inflammation and coagulopathy do not fully normalize despite virologic suppression and persistent immune activation is an important contributor to SNAEs. A number of strategies aimed to reduce persistent immune activation including ART intensification to reduce residual viremia; treatment of co-infections to reduce chronic antigen stimulation; the use of anti-inflammatory agents, reducing microbial translocation as well as interventions to improve immune recovery through cytokine administration and reducing lymphoid tissue fibrosis, have been investigated...
April 2016: Drugs
Robyn G M Weijma, Eric R A Vos, Jaap Ten Oever, Muriel Van Schilfgaarde, Lea M Dijksman, André Van Der Ven, Guido E L Van Den Berk, Kees Brinkman, Jos P H J Frissen, Anja Leyte, Ineke W E M Schouten, Mihai G Netea, Willem L Blok
Background.  Immune activation has been implicated in the excess mortality in human immunodeficiency virus (HIV)-infected patients, due to cardiovascular diseases and malignancies. Statins may modulate this immune activation. We assessed the capacity of rosuvastatin to mitigate immune activation in treatment-naive HIV-infected patients. Methods.  In a randomized double-blind placebo-controlled crossover study, we explored the effects of 8 weeks of rosuvastatin 20 mg in treatment-naive male HIV-infected patients (n = 28) on immune activation markers: neopterin, soluble Toll-like receptor (TLR)2, sTLR4, interleukin (IL)-6, IL-1Ra, IL-18, d-dimer, highly sensitive C-reactive protein, and CD38 and/or human leukocyte antigen-DR expression on T cells...
January 2016: Open Forum Infectious Diseases
Corrilynn O Hileman, Randi Turner, Nicholas T Funderburg, Richard D Semba, Grace A McComsey
BACKGROUND: Oxidative stress plays a significant role in atherosclerosis development. HIV infection has been linked with heightened cardiovascular disease risk. HMG-CoA reductase inhibitors may reduce oxidative stress and subsequently subclinical vascular disease in HIV. DESIGN/METHODS: This is a randomized, placebo-controlled trial to evaluate the effect of rosuvastatin in HIV-infected adults on stable antiretroviral therapy with low-density lipoprotein less than 130  mg/dl and increased inflammation or T-cell activation on subclinical vascular disease...
January 2, 2016: AIDS
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