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Hiv cardiovascular disease

Herman G Sprenger, Wouter F Bierman, Melanie I Martes, Reindert Graaff, Tjip S Van Der Werf, Andries J Smit
OBJECTIVE: HIV-1 infection is associated with an increased cardiovascular disease (CVD) risk. Advanced glycation end products (AGEs) are formed as stable markers of glycemic and oxidative stress. Skin autofluorescence (SAF) as marker of accumulated AGEs is increased and predictive of CVD events in diabetes mellitus, chronic kidney disease (CKD) and pre-existing CVD. We determined SAF levels in HIV-1 infected patients, testing the hypothesis that SAF predicts CVD events in HIV infection...
October 18, 2016: AIDS
Edward J Wing
With the wider availability of antiretrovirals, the world's HIV population is aging. More than 10% of the 34.5 million HIV+ individuals worldwide are over the age of 50 and the average age continues to increase. In the US more than 50% of the 1.3 million people with HIV are over 50 and by the year 2030 it is estimated that 70% will be over the age of 50. Although the life expectancy of HIV+ people has increased dramatically, it still lags behind HIV- individuals. There is controversy about whether HIV itself accelerates the aging process...
October 15, 2016: International Journal of Infectious Diseases: IJID
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
Vibe Ballegaard, Ulrik Ralfkiaer, Karin K Pedersen, Malene Hove, Simon Koplev, Peter Brændstrup, Lars P Ryder, Hans O Madsen, Jan Gerstoft, Kirsten Grønbæk, Susanne D Nielsen
OBJECTIVE: Inflammation may contribute to increased risk of cardiovascular disease (CVD) in HIV-1 infection. MicroRNAs (miRNAs) are involved in the regulation of inflammation. In treated HIV-1-infected individuals, we aimed to identify differentially expressed miRNAs with known roles in inflammation and CVD risk, and to investigate associations between these and systemic inflammation. METHODS: In a screening cohort including 14 HIV-1-infected individuals and nine uninfected controls microarray profiling was performed using peripheral blood mononuclear cells (PBMC)...
October 3, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
David B Hanna, Molly Jung, Xiaonan Xue, Kathryn Anastos, Jennifer M Cocohoba, Mardge H Cohen, Elizabeth T Golub, Nancy A Hessol, Alexandra M Levine, Tracey E Wilson, Mary A Young, Robert C Kaplan
Cardiovascular disease (CVD) is increasingly common among women with HIV, but literature on nonlipid CVD risk factor management is lacking. We examined semiannual trends from 2006 to 2014 in hypertension treatment and control (blood pressure <140/90 mmHg), diabetes treatment and control (fasting glucose <130 mg/dL), and smoking quit rates in the Women's Interagency HIV Study. Unadjusted and adjusted Poisson regression models tested time trends and differences between HIV+ and HIV- women. Among antiretroviral therapy (ART) users, we examined the association of ART adherence and virologic suppression with each outcome...
October 2016: AIDS Patient Care and STDs
Mitch M Matoga, Mina C Hosseinipour, Evgenia Aga, Heather J Ribaudo, Nagalingeswaran Kumarasamy, John Bartlett, Michael D Hughes
BACKGROUND: Cardiovascular disease (CVD) is an emerging concern for HIV-infected patients. Hyperlipidemia is a risk factor for CVD and a complication of protease-inhibitor-based antiretroviral therapy, but little is known about its incidence and risk factors in treated patients in resource-limited settings (RLS). METHODS: We conducted a secondary analysis of ACTG A5230 trial in which HIV-infected adults from India, Malawi, Tanzania, Thailand and South Africa, with virologic relapse on first line therapy were initiated on lopinavir/ritonavir (LPV/r) monotherapy...
October 14, 2016: Antiviral Therapy
Nicholas T Funderburg, Dihua Xu, Martin P Playford, Aditya A Joshi, Adriana Andrade, Daniel R Kuritzkes, Michael M Lederman, Nehal N Mehta
BACKGROUND: Persons infected with HIV often have altered lipid profiles that may be affected by antiretroviral therapies (ART). Traditional lipid measurements may be insufficient to assess cardiovascular disease (CVD) risk in this population. METHODS: We report results from 39 ART-naïve participants in a substudy of A5248, a single-arm study of raltegravir (RAL), emtricitabine/tenofovir administration. Samples were collected at baseline, 12, 24, and 48 weeks after ART initiation...
October 14, 2016: Antiviral Therapy
Matthew J Feinstein, Brian Poole, Pedro Engel Gonzalez, Anna E Pawlowski, Daniel Schneider, Tim S Provias, Frank J Palella, Chad J Achenbach, Donald M Lloyd-Jones
BACKGROUND: HIV-infected persons develop coronary artery disease (CAD) more commonly and earlier than uninfected persons; however, the role of non-invasive testing to stratify CAD risk in HIV is not well defined. METHODS AND RESULTS: Patients were selected from a single-center electronic cohort of HIV-infected patients and uninfected controls matched 1:2 on age, sex, race, and type of cardiovascular testing performed. Patients with abnormal echocardiographic or nuclear stress testing who subsequently underwent coronary angiography were included...
October 13, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Matthew J Feinstein, Milana Bogorodskaya, Gerald S Bloomfield, Rajesh Vedanthan, Mark J Siedner, Gene F Kwan, Christopher T Longenecker
Effective combination antiretroviral therapy (ART) has enabled human immunodeficiency virus (HIV) infection to evolve from a generally fatal condition to a manageable chronic disease. This transition began two decades ago in high-income countries and has more recently begun in lower income, HIV endemic countries (HIV-ECs). With this transition, there has been a concurrent shift in clinical and public health burden from AIDS-related complications and opportunistic infections to those associated with well-controlled HIV disease, including cardiovascular disease (CVD)...
November 2016: Current Cardiology Reports
Kalpana J Kallianpur, Marissa Sakoda, Louie Mar A Gangcuangco, Lishomwa C Ndhlovu, Tracie Umaki, Dominic Chow, Suwarat Wongjittraporn, Cecilia M Shikuma
BACKGROUND: Chronic HIV disease is associated with neurocognitive impairment and age-related conditions such as frailty. OBJECTIVE: To determine whether regional brain volumetric changes correlate with frailty parameters in older (≥ 40 years) HIV+ patients on stable combination antiretroviral therapy. METHOD: Thirty-five HIV-infected participants in the Hawaii Aging with HIV Cohort - Cardiovascular Disease study underwent T1-weighted brain magnetic resonance imaging, frailty assessment and neuropsychological testing...
2016: Open Medicine Journal
Eva Poveda, Manuel Crespo
Highly active antiretroviral therapy (ART) has allowed a long-term control of viral replication and HIV infection has been transformed into a chronic disease. However, ART is not able to eradicate the virus, and high levels of inflammation and immune-activation are observed despite prolonged ART. Consequently, a number of comorbidities, such as cardiovascular diseases and cancer, are gaining relevance in patients living with HIV. Moreover, the toxicities associated with continued exposure to ART cause several metabolic disturbances with clinical relevance, and the cost of treatment is a heavy burden for the national health systems...
July 2016: AIDS Reviews
Davy Vancampfort, James Mugisha, Simon Rosenbaum, Joseph Firth, Marc De Hert, Michel Probst, Brendon Stubbs
Cardiorespiratory fitness (CRF) is a modifiable risk factor for cardiovascular disease and premature mortality. CRF levels and moderators among people living with HIV (PLWH) are unknown. The aim of the current meta-analysis was to (1) determine mean CRF in PLWH and compare levels with age- and gender-matched healthy controls (HCs), (2) explore moderators of CRF, (3) and (4) explore moderators of CRF outcomes following physical activity (PA) interventions. Major electronic databases were searched systematically for articles reporting CRF expressed as maximum or peak oxygen uptake (ml/min/kg) in PLWH...
October 3, 2016: Preventive Medicine
Jean-Jacques Monsuez, Catherine Belin, Olivier Bouchaud
Combined antiretroviral therapy (CART) has turned HIV-infection to a treatable chronic disease during which many patients survive to middle and older age. However, they prematurely develop non-AIDS comorbidities such as cardiovascular disease, metabolic syndrome, diabetes, and HIV-associated neurocognitive disorders (HAND). Microcirculatory changes and endothelial dysfunction occur early both in HIV-infected and in aging patients, in whom they usually precede cardiovascular and neurocognitive impairments. Also, mild cognitive involvement has been reported in women during the menopausal transition...
October 5, 2016: Current HIV/AIDS Reports
Joseph C Mudd, Soumya Panigrahi, Benjamin Kyi, So Hee Moon, Maura M Manion, Souheil-Antoine Younes, Scott F Sieg, Nicholas T Funderburg, David A Zidar, Michael M Lederman, Michael L Freeman
Increases in inflammation, coagulation, and CD8 T cell numbers are associated with elevated cardiovascular disease (CVD) risk in antiretroviral therapy (ART)-treated HIV infection. Circulating memory CD8 T cells that express the vascular endothelium-homing receptor CX3CR1 (fractalkine receptor) are enriched in ART-treated HIV-infected subjects. Thrombin-activated receptor (PAR-1) expression is increased in ART-treated HIV-infected subjects and is particularly elevated on CX3CR1+ CD8 T cells, suggesting that these cells could interact with coagulation elements...
October 4, 2016: Journal of Infectious Diseases
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
Justin M Cournoyer, Aven P Garms, Kimberly N Thiessen, Margaret T Bowers, Melissa D Johnson, Michael V Relf
HIV infection has progressed from an acute, terminal disease to a chronic illness with cardiovascular disease as the leading cause of death among persons living with HIV. As persons living with HIV infection continue to become older, traditional risk factors for atherosclerosis compounded by the pathophysiological effects of HIV infection and antiretroviral therapy markedly increase the risk for cardiovascular disease. Further, persons living with HIV are also at high risk for cardiomyopathy. Critical care nurses must recognize the risk factors for cardiovascular disease and the pathophysiology and complex treatment options in order to manage care of these patients and facilitate multidisciplinary collaboration...
October 2016: Critical Care Nurse
Katherine W Kooij, Ferdinand W N M Wit, Thijs Booiman, Marc van der Valk, Maarten F Schim van der Loeff, Neeltje A Kootstra, Peter Reiss
Smoking may affect cardiovascular disease risk more strongly in HIV-infected compared to HIV-uninfected individuals. We hypothesized that an interaction at the level of the immune system may contribute to this increased risk. We assessed soluble markers of inflammation (high-sensitivity C-reactive protein [hsCRP]), immune activation (soluble [s]CD14 and sCD163) and coagulation (D-dimer) in HIV-infected and uninfected never, former and current smokers. Smoking was independently associated with higher hsCRP levels and lower sCD163 levels, and at borderline significance with higher sCD14 and D-dimer levels; we found no evidence of a differential effect of smoking in HIV-infected compared to uninfected individuals...
September 28, 2016: Journal of Infectious Diseases
Dominic Chow, Cecilia Shikuma, Corey Ritchings, Muxing Guo, Lisa Rosenblatt
INTRODUCTION: Patients with human immunodeficiency virus (HIV) infection have an increased risk of cardiovascular disease (CVD). While viral suppression with antiretroviral therapy decreases CVD risk overall, several studies have suggested that certain antiretrovirals, particularly certain protease inhibitors, may be associated with an increased relative risk of CVD. In AIDS Clinical Trials Group 5260 s, ritonavir-boosted atazanavir (ATV) was associated with slower atherosclerosis progression compared to ritonavir-boosted darunavir and raltegravir, potentially due to hyperbilirubinemia...
September 27, 2016: Infectious Diseases and Therapy
Rebecca Scherzer, Steven B Heymsfield, David Rimland, William G Powderly, Phyllis C Tien, Peter Bacchetti, Michael G Shlipak, Carl Grunfeld
OBJECTIVE: Liver disease markers have been associated with mortality in HIV-infected individuals, in the modern era of effective antiretroviral therapy. Our objective was to determine which markers are most predictive of mortality in HIV-monoinfected and HIV/HCV-coinfected persons. RESEARCH DESIGN AND METHODS: We measured serum albumin, total protein, calculated globulin, aspartate transaminase (AST), and alanine transaminase (ALT) in 193 HIV/HCV-coinfected and 720 HIV-monoinfected persons in the study of Fat Redistribution and Metabolic Change in HIV Infection...
September 24, 2016: AIDS
Andreas Kuznik, Garba Iliyasu, Abdulrazaq G Habib, Baba M Musa, Andrew Kambugu, Mohammed Lamorde
OBJECTIVE: In 2015, the World Health Organization (WHO) recommended initiation of antiretroviral therapy (ART) in all HIV-positive patients regardless of CD4 cell count. We evaluated the cost-effectiveness of immediate versus deferred ART initiation among patients with CD4 counts exceeding 500 cells/mm in four resource-limited countries (South Africa, Nigeria, Uganda, and India). DESIGN: A 5-year Markov model with annual cycles including patients at CD4>500 cells/mm initiating ART or deferring therapy until historic ART initiation criteria of CD < 350 cells/mm were met...
September 20, 2016: AIDS
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