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Asgedom YS, Kebede TM, Gebrekidan AY, Koyira MM, Azeze GA, Lombebo AA, Efa AG, Haile KE, Kassie GA. Prevalence of metabolic syndrome among people living with human immunodeficiency virus in sub-Saharan Africa: a systematic review and meta-analysis. Sci Rep 2024; 14:11709. [PMID: 38777850 PMCID: PMC11111734 DOI: 10.1038/s41598-024-62497-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 05/17/2024] [Indexed: 05/25/2024] Open
Abstract
Metabolic syndrome (MetS) poses a significant clinical challenge for individuals living with HIV (PLHIV). In sub-Saharan Africa (SSA), this condition is becoming a growing concern, owing to lifestyle changes and an increasingly aging population. Several SSA countries have reported on the prevalence of MetS. However, these estimates may be outdated because numerous recent studies have updated MetS prevalence among PLHIV in these countries. Moreover, prior research has focused on various study designs to report the pooled prevalence, which is a methodological limitation. Therefore, this systematic review and meta-analysis aimed to determine the pooled estimates of MetS in PLHIV in SSA by addressing these gaps. We systematically searched Google Scholar, Science Direct, Scopus, Web of Sciences, EMBASE, and PubMed/Medline for the prevalence of MetS and its subcomponents among people with HIV in sub-Saharan Africa. The estimated pooled prevalence was presented using a forest plot. Egger's and Begg's rank regression tests were used to assess evidence of publication bias. Twenty-five studies fulfilled the inclusion criteria after review of the updated PRISMA guidelines. The pooled prevalence of MetS was 21.01% [95% CI: (16.50, 25.51)] and 23.42% [95% CI: (19.16, 27.08)] to the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III) and International Diabetes Federation (IDF) criteria, respectively. Low levels of high-density lipoprotein cholesterol (Low HDL) at 47.25% [95% CI: 34.17, 60.33)] were the highest reported individual subcomponent, followed by abdominal obesity at 38.44% [95% CI: (28.81, 48.88)]. The prevalence of MetS is high in sub-Saharan Africa. Low HDL levels and increased waist circumference/abdominal obesity were the most prevalent components of MetS. Therefore, early screening for MetS components and lifestyle modifications is required. Policymakers should develop strategies to prevent MetS before an epidemic occurs.PROSPERO: CRD42023445294.
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Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Barone Gibbs B, Beaton AZ, Boehme AK, Commodore-Mensah Y, Currie ME, Elkind MSV, Evenson KR, Generoso G, Heard DG, Hiremath S, Johansen MC, Kalani R, Kazi DS, Ko D, Liu J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Perman SM, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Tsao CW, Urbut SM, Van Spall HGC, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Palaniappan LP. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation 2024; 149:e347-e913. [PMID: 38264914 DOI: 10.1161/cir.0000000000001209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Girma D, Dejene H, Geleta LA, Malka ES, Tesema M, Awol M, Oyato BT. Metabolic syndrome among people living with HIV in Ethiopia: a systematic review and meta-analysis. Diabetol Metab Syndr 2023; 15:61. [PMID: 36978109 PMCID: PMC10045608 DOI: 10.1186/s13098-023-01034-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 03/18/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Human Immuno-deficiency Virus (HIV) infection and antiretroviral therapy (ART) can cause metabolic disorders such as lipodystrophy, dyslipidemia, and insulin resistance, all of which are symptoms of metabolic syndrome (MetS). In Ethiopia, despite the existence of the primary studies, there was no pooled study conducted to summarize the country-level MetS among people living with HIV (PLHIV). Therefore, this study aims to estimate the pooled prevalence of MetS among PLHIV in Ethiopia. METHODS A systematic search was conducted to retrieve studies on the prevalence of MetS among PLHIV in Ethiopia from PubMed, Google Scholar, Science Direct, Web of Sciences, HINARI, and other relevant sources. A random-effects model was used to estimate the MetS in this study. The overall variation between studies was checked by the heterogeneity test (I2). The Joanna Briggs Institute (JBI) quality appraisal criteria were used to assess the quality of the studies. The summary estimates were presented with forest plots and tables. Publication bias was checked with the funnel plot and Egger's regression test. RESULTS Overall, 366 articles were identified and evaluated using the PRISMA guidelines, with 10 studies meeting the inclusion criteria included in the final analysis. The pooled prevalence of MetS among PLHIV in Ethiopia was 21.7% (95% CI:19.36-24.04) using National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III) and 29.91% (95% CI: 21.54-38.28) using International Diabetes Federation (IDF) criteria. The lowest and highest prevalence of MetS were 19.14% (95%CI: 15.63-22.64) and 25.6% (95%CI: 20.18-31.08) at Southern Nation and Nationality People Region (SNNPR) and Addis Ababa, respectively. There was no statistical evidence of publication bias in both NCEP-ATP III and IDF pooled estimates. CONCLUSION MetS was common among PLHIV in Ethiopia. Therefore, optimizing regular screening for MetS components and promoting a healthy lifestyle is suggested for PLHIV. Furthermore, more study is contributory to identify the barriers to implementing planned interventions and meeting recommended treatment goals. TRIAL REGISTRATION The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO): CRD42023403786.
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Affiliation(s)
- Derara Girma
- Public Health Department, College of Health Sciences, Salale University, Fiche, Ethiopia
| | - Hiwot Dejene
- Public Health Department, College of Health Sciences, Salale University, Fiche, Ethiopia
| | - Leta Adugna Geleta
- Public Health Department, College of Health Sciences, Salale University, Fiche, Ethiopia
| | - Erean Shigign Malka
- Public Health Department, College of Health Sciences, Salale University, Fiche, Ethiopia
| | - Mengistu Tesema
- Public Health Department, College of Health Sciences, Salale University, Fiche, Ethiopia
| | - Mukemil Awol
- Department of Midwifery, College of health sciences, Salale University, Fiche, Ethiopia
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Tsao CW, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Beaton AZ, Boehme AK, Buxton AE, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Fugar S, Generoso G, Heard DG, Hiremath S, Ho JE, Kalani R, Kazi DS, Ko D, Levine DA, Liu J, Ma J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Virani SS, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association. Circulation 2023; 147:e93-e621. [PMID: 36695182 DOI: 10.1161/cir.0000000000001123] [Citation(s) in RCA: 1076] [Impact Index Per Article: 1076.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year's worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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5
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Duan Y, Zhao H, Tang W, Chen M, Liu X, Yang D, Gao G, Xiao J, Han N, Liang H, Wu L, Ni L, Wang F, Song Y, Xie X, Zhang F. Longitudinal analysis of new-onset non-AIDS-defining diseases among people living with HIV: A real-world observational study. HIV Med 2022; 23 Suppl 1:32-41. [PMID: 35293109 DOI: 10.1111/hiv.13247] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVES We aimed to analyze the incidence rates of new-onset diabetes, hypertriglyceridemia, hypercholesterolemia, liver injury, and renal injury during antiretroviral therapy (ART) among people living with HIV (PLWH) and determine the associated risk factors. METHODS This study included PLWH enrolled from Beijing Ditan Hospital from November 11, 2004, to December 29, 2018. The incidence rates of new-onset diabetes, hypertriglyceridemia, hypercholesterolemia, liver injury, and renal injury were calculated and stratified based on ART regimen, CD4 count, and HIV-RNA. Risk factors were determined using Cox regression analysis. RESULTS Overall, 6747 participants were included. Moreover, 4.5%, 43.3%, 25.4%, 11.2%, and 6.2% of patients developed new-onset diabetes, hypertriglyceridemia, hypercholesterolemia, liver injury, and renal injury, respectively, with incidence rates of 1.7, 26.9, 10.2, 3.9, and 5.5 per 100 person-years, respectively. Longitudinally, the incidence rates and percentages of these outcomes were highest in the first year of ART. The percentage of dyslipidemia was significantly higher in protease inhibitor (PI)-based regimen than in non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimen. However, the percentage of liver injury was significantly higher in NNRTI-based regimen than in PI-based regimen. In multivariate Cox regression analysis, low CD4 count (<200 cells/µL, adjusted hazard ratio [aHR] = 1.34, 95% confidence interval [CI] 1.15-1.57) and high HIV-RNA (>105 copies/mL, aHR = 1.26, 95% CI 1.08-1.48) were risk factors for hypertriglyceridemia. CONCLUSIONS Clinical outcomes, including new-onset diabetes, dyslipidemia, and liver and renal injuries, are common in PLWH. Regular glucose, lipid, liver, and renal function monitoring is required during ART, especially in high-risk patients.
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Affiliation(s)
- Yujiao Duan
- Beijing Ditan Hospital, Capital Medical University, Beijing, China.,Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China
| | - Hongxin Zhao
- Beijing Ditan Hospital, Capital Medical University, Beijing, China.,Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China
| | - Weiming Tang
- University of North Carolina Project-China, Guangzhou, China
| | - Meiling Chen
- Beijing Ditan Hospital, Capital Medical University, Beijing, China.,Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China
| | - Xuan Liu
- North Carolina State University, Raleigh, North Carolina, USA
| | - Di Yang
- Beijing Ditan Hospital, Capital Medical University, Beijing, China.,Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China
| | - Guiju Gao
- Beijing Ditan Hospital, Capital Medical University, Beijing, China.,Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China
| | - Jiang Xiao
- Beijing Ditan Hospital, Capital Medical University, Beijing, China.,Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China
| | - Ning Han
- Beijing Ditan Hospital, Capital Medical University, Beijing, China.,Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China
| | - Hongyuan Liang
- Beijing Ditan Hospital, Capital Medical University, Beijing, China.,Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China
| | - Liang Wu
- Beijing Ditan Hospital, Capital Medical University, Beijing, China.,Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China
| | - Liang Ni
- Beijing Ditan Hospital, Capital Medical University, Beijing, China.,Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China
| | - Fang Wang
- Beijing Ditan Hospital, Capital Medical University, Beijing, China.,Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China
| | - Yangzi Song
- Beijing Ditan Hospital, Capital Medical University, Beijing, China.,Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China
| | - Xiaohui Xie
- Peking University Ditan Teaching Hospital, Beijing, China
| | - Fujie Zhang
- Beijing Ditan Hospital, Capital Medical University, Beijing, China.,Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China
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Amador-Lara F, Andrade-Villanueva JF, Vega-Magaña N, Peña-Rodríguez M, Alvarez-Zavala M, Sanchez-Reyes K, Toscano-Piña M, Peregrina-Lucano AA, Del Toro-Arreola S, González-Hernández LA, Bueno-Topete MR. Gut microbiota from Mexican patients with metabolic syndrome and HIV infection: an inflammatory profile. J Appl Microbiol 2022; 132:3839-3852. [PMID: 35218591 DOI: 10.1111/jam.15505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 11/30/2022]
Abstract
AIM A remarkable increase in metabolic syndrome (MetS) has occurred in HIV-infected subjects. Gut dysbiosis is involved in the pathogenesis of metabolic disorders. Therefore, the aim is to explore the profile of the gut microbiota in Mexican population with HIV infection and MetS. METHODS AND RESULTS Thirty HIV-infected patients with MetS compared to a group of 30 patients without MetS, treated with integrase inhibitors and undetectable viral load were included in the study. Stool samples were analysed by 16S rRNA next-generation sequencing. High sensitivity C-reactive protein >3mg l-1 and higher scores in cardiometabolic indices were associated with MetS. The group with MetS was characterized by a decrease in α-diversity, higher abundance of Enterobacteriaceae and Prevotella, as well as a dramatic decrease in bacteria producing short-chain fatty acids. Prevotella negatively correlated with Akkermansia, Lactobacillus, and Anaerostipes. Interestingly, the group without MetS presented higher abundance of Faecalibacterium, Ruminococcus, Anaerofilum, Oscillospira and Anaerostipes. Functional pathways related to energy metabolism and inflammation were increased in the group with MetS. CONCLUSIONS HIV-infected patients with MetS present a strong inflammatory microbiota profile; therefore, future strategies to balance intestinal dysbiosis should be implemented. SIGNIFICANCE AND IMPACT OF STUDY Dysbiosis in MetS HIV-infected patients is a promising therapeutic target.
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Affiliation(s)
- Fernando Amador-Lara
- Unidad de VIH, Hospital Civil de Guadalajara "Fray Antonio Alcalde", Hospital #278, colonia el Retiro, CP 44280, Guadalajara, Jalisco, México.,Instituto de Investigación en Inmunodeficiencias y VIH (InIVIH), Departamento de Clínicas Médicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Hospital #278, colonia el Retiro, CP 44280, Guadalajara, Jalisco, México
| | - Jaime F Andrade-Villanueva
- Unidad de VIH, Hospital Civil de Guadalajara "Fray Antonio Alcalde", Hospital #278, colonia el Retiro, CP 44280, Guadalajara, Jalisco, México.,Instituto de Investigación en Inmunodeficiencias y VIH (InIVIH), Departamento de Clínicas Médicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Hospital #278, colonia el Retiro, CP 44280, Guadalajara, Jalisco, México
| | - Natali Vega-Magaña
- Laboratorio de Diagnóstico de Enfermedades Emergentes y Reemergentes (LaDEER), Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada # 950, Colonia Independencia, CP 44340, Guadalajara, Jalisco, México.,Instituto de Investigación en Ciencias Biomédicas (IICB), Departamento de Clínicas Médicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada # 950, Colonia Independencia, CP 44340, Guadalajara, Jalisco, México
| | - Marcela Peña-Rodríguez
- Instituto de Investigación en Enfermedades Crónico-Degenerativas (IECD), Departamento de Biología Molecular y Genómica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada # 950, Colonia Independencia, CP 44340, Guadalajara, Jalisco, México
| | - Monserrat Alvarez-Zavala
- Unidad de VIH, Hospital Civil de Guadalajara "Fray Antonio Alcalde", Hospital #278, colonia el Retiro, CP 44280, Guadalajara, Jalisco, México.,Instituto de Investigación en Inmunodeficiencias y VIH (InIVIH), Departamento de Clínicas Médicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Hospital #278, colonia el Retiro, CP 44280, Guadalajara, Jalisco, México
| | - Karina Sanchez-Reyes
- Unidad de VIH, Hospital Civil de Guadalajara "Fray Antonio Alcalde", Hospital #278, colonia el Retiro, CP 44280, Guadalajara, Jalisco, México.,Instituto de Investigación en Inmunodeficiencias y VIH (InIVIH), Departamento de Clínicas Médicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Hospital #278, colonia el Retiro, CP 44280, Guadalajara, Jalisco, México
| | - Marcela Toscano-Piña
- Unidad de VIH, Hospital Civil de Guadalajara "Fray Antonio Alcalde", Hospital #278, colonia el Retiro, CP 44280, Guadalajara, Jalisco, México
| | - Alejandro A Peregrina-Lucano
- Departamento de Farmacobiología; Centro Universitario de Ciencias Exactas e Ingenierías, Universidad de Guadalajara, Blvd. Marcelino García Barragán #1421, esq. Olímpica, C.P. 44430, Guadalajara, Jalisco, México
| | - Susana Del Toro-Arreola
- Instituto de Investigación en Enfermedades Crónico-Degenerativas (IECD), Departamento de Biología Molecular y Genómica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada # 950, Colonia Independencia, CP 44340, Guadalajara, Jalisco, México
| | - Luz A González-Hernández
- Unidad de VIH, Hospital Civil de Guadalajara "Fray Antonio Alcalde", Hospital #278, colonia el Retiro, CP 44280, Guadalajara, Jalisco, México.,Instituto de Investigación en Inmunodeficiencias y VIH (InIVIH), Departamento de Clínicas Médicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Hospital #278, colonia el Retiro, CP 44280, Guadalajara, Jalisco, México
| | - Miriam R Bueno-Topete
- Instituto de Investigación en Enfermedades Crónico-Degenerativas (IECD), Departamento de Biología Molecular y Genómica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada # 950, Colonia Independencia, CP 44340, Guadalajara, Jalisco, México
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Iqbal S, Salman S, Akhtar M, Bhalli A, Iqbal J, Ullah I. Spectrum of Dyslipidemias in Treatment-Naïve Human Immunodeficiency Virus-Infected Patients Presenting to an HIV Clinic of a Tertiary Care Hospital. Cureus 2022; 14:e21972. [PMID: 35282542 PMCID: PMC8906539 DOI: 10.7759/cureus.21972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction HIV/AIDS is a major communicable disease worldwide, especially in developing countries where disease prevalence is over 90%. The National AIDS Control Programme of Pakistan reported around 160,000 HIV cases (140,000-190,000) with a 5% prevalence among traditional risks groups. HIV infection is thought to affect lipids metabolism adversely, thus resulting in increased morbidity and mortality. The aim of the study was to find out the frequency and types of dyslipidemia in patients with HIV not taking anti-retroviral therapy, presenting to an HIV clinic at a tertiary care hospital. Methods This cross-sectional study was conducted at the HIV clinic of Jinnah Hospital from January 2020 to July 2020. A total of 280 treatment-naïve patients, fulfilling the inclusion protocol, were included through non-probability consecutive sampling after informed consent. Blood samples of 5 mL were taken using aseptic measures and following standard procedure after ensuring overnight fasting by a nurse and were sent immediately to the pathology laboratory of Allama Iqbal Medical College. The results of the lipid profile were collected the next day and noted in the proforma. Dyslipidemia and type of dyslipidemia were recorded as per operational definition. Data were analyzed by SPSS software, version 27.0 (IBM Corp., Armonk, NY). Cross-tabulation was done to assess the relationship of gender, BMI, and family history on dyslipidemia, and a chi-square test was applied to check statistical significance. Results Among 280 treatment-naïve HIV-infected patients, the majority of patients were females (52%). The mean duration of HIV was 9.31 + 2.13 months. About 55% of patients had a BMI of more than 25 kg m2. A family history of dyslipidemia was found in 62% of the patients. Dyslipidemia was observed in 70% of patients with maximum derangement seen in total cholesterol level (62%). After applying the chi-square test, a significant relation was identified between BMI and family history with dyslipidemia in HIV-infected individuals (p-value = 0.00). Conclusion A considerable proportion of treatment-naïve HIV patients have underlying dyslipidemia with a significant relationship with higher BMI and a family history of dyslipidemia. The findings of this study highlight the importance of early screening for dyslipidemia in HIV patients.
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8
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Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, Boehme AK, Buxton AE, Carson AP, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Ferguson JF, Generoso G, Ho JE, Kalani R, Khan SS, Kissela BM, Knutson KL, Levine DA, Lewis TT, Liu J, Loop MS, Ma J, Mussolino ME, Navaneethan SD, Perak AM, Poudel R, Rezk-Hanna M, Roth GA, Schroeder EB, Shah SH, Thacker EL, VanWagner LB, Virani SS, Voecks JH, Wang NY, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association. Circulation 2022; 145:e153-e639. [PMID: 35078371 DOI: 10.1161/cir.0000000000001052] [Citation(s) in RCA: 2300] [Impact Index Per Article: 1150.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2022 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population and an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, and the global burden of cardiovascular disease and healthy life expectancy. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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9
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Dash PK, Alomar FA, Cox JL, McMillan J, Hackfort BT, Makarov E, Morsey B, Fox HS, Gendelman HE, Gorantla S, Bidasee KR. A Link Between Methylglyoxal and Heart Failure During HIV-1 Infection. Front Cardiovasc Med 2022; 8:792180. [PMID: 34970611 PMCID: PMC8712558 DOI: 10.3389/fcvm.2021.792180] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 11/22/2021] [Indexed: 01/11/2023] Open
Abstract
Early-onset heart failure (HF) continues to be a major cause of morbidity and mortality in people living with human immunodeficiency virus type one (HIV-1) infection (PLWH), yet the molecular causes for this remain poorly understood. Herein NOD.Cg-PrkdcscidIl2rgtm1Wjl/SzJ humanized mice (Hu-mice), plasma from PLWH, and autopsied cardiac tissues from deceased HIV seropositive individuals were used to assess if there is a link between the glycolysis byproduct methylglyoxal (MG) and HF in the setting of HIV-1 infection. At five weeks post HIV infection, Hu-mice developed grade III-IV diastolic dysfunction (DD) with an associated two-fold increase in plasma MG. At sixteen-seventeen weeks post infection, cardiac ejection fraction and fractional shortening also declined by 26 and 35%, and plasma MG increased to four-fold higher than uninfected controls. Histopathological and biochemical analyses of cardiac tissues from Hu-mice 17 weeks post-infection affirmed MG increase with a concomitant decrease in expression of the MG-degrading enzyme glyoxalase-1 (Glo1). The endothelial cell marker CD31 was found to be lower, and coronary microvascular leakage and myocardial fibrosis were prominent. Increasing expression of Glo1 in Hu-mice five weeks post-infection using a single dose of an engineered AAV2/9 (1.7 × 1012 virion particles/kg), attenuated the increases in plasma and cardiac MG levels. Increasing Glo1 also blunted microvascular leakage, fibrosis, and HF seen at sixteen weeks post-infection, without changes in plasma viral loads. In plasma from virally suppressed PLWH, MG was also 3.7-fold higher. In autopsied cardiac tissues from seropositive, HIV individuals with low viral log, MG was 4.2-fold higher and Glo1 was 50% lower compared to uninfected controls. These data show for the first time a causal link between accumulation of MG and HF in the setting of HIV infection.
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Affiliation(s)
- Prasanta K Dash
- Departments of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, United States
| | - Fadhel A Alomar
- Department of Pharmacology and Toxicology, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Jesse L Cox
- Departments of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, United States
| | - JoEllyn McMillan
- Departments of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, United States
| | - Bryan T Hackfort
- Departments of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, United States
| | - Edward Makarov
- Departments of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, United States
| | - Brenda Morsey
- Departments of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, United States
| | - Howard S Fox
- Departments of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, United States
| | - Howard E Gendelman
- Departments of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, United States
| | - Santhi Gorantla
- Departments of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, United States
| | - Keshore R Bidasee
- Departments of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, United States.,Departments of Environment and Occupational Health, University of Nebraska Medical Center, Omaha, NE, United States.,Nebraska Redox Biology Center, Lincoln, NE, United States
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10
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Quiles N, Ortiz A. Prevalence of Cardiometabolic Risk Factors Among People Living with HIV in Southern Texas. AIDS Res Hum Retroviruses 2021; 37:862-869. [PMID: 34139880 DOI: 10.1089/aid.2021.0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of this study is to estimate the prevalence of cardiometabolic risk factors among people living with HIV (PLWH) in the south Texas region between 2014 and 2018. A total of 2,808 PLWH from the southern Texas region were included using electronic medical records from a combination of health care system databases. The prevalence of cardiometabolic factors such as elevated blood pressure (BP), triglycerides, total cholesterol and blood glucose, low high-density lipoprotein cholesterol (HDL-C), and obesity was evaluated. The association between cardiometabolic risk factors and age, sex, race/ethnicity, and HIV-related variables was evaluated using logistic regression. Approximately 50.8% had elevated BP, followed by low HDL-C (41.7%), elevated glucose (40.3%), elevated triglycerides (35.5%), obesity (27.8%), and elevated total cholesterol (20%). Hispanics had a higher prevalence of low HDL-C (45.5% vs. 39.7%, p = .012), elevated glucose (48.9% vs. 36.3%, p < .001), elevated triglycerides (40.4% vs. 33.0%, p = .001), and obesity (31.3% vs. 26.0%, p = .004) than non-Hispanics. Females had a higher prevalence of low HDL-C (51.9% vs. 39.1%, p < .001), elevated total cholesterol (24.4% vs. 18.8%, p = .010), and obesity (49.5% vs. 21.8%, p < .001) than males. Variables such as age, sex, race/ethnicity, CD4+ T cell count, and viral load use were associated with multiple cardiometabolic risk factors. The prevalence of cardiometabolic risk factors remains high among PLWH in the southern Texas region, especially among Hispanics and females.
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Affiliation(s)
- Norberto Quiles
- Department of Family, Nutrition and Exercise Sciences, Queens College of The City University of New York, Flushing, New York, USA
| | - Alexis Ortiz
- School of Physical Therapy, University of the Incarnate Word, San Antonio, Texas, USA
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11
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Nguyen A, Rinaldi S, Martinez C, Perkins M, Holstad MM. "HIV and Aging in Special Populations: From the Mitochondria to the Metropolis"-Proceedings From the 2019 Conference. J Assoc Nurses AIDS Care 2021; 32:214-221. [PMID: 33449580 PMCID: PMC9272905 DOI: 10.1097/jnc.0000000000000236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Annie Nguyen
- Department of Family Medicine, Keck School of Medicine, University of Southern California, San Diego, California, USA
| | - Stefano Rinaldi
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Claudia Martinez
- Clinical Medicine, Department of Medicine, Division of Cardiology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Molly Perkins
- Associate Professor, Emory University School of Medicine; a Member of the Graduate Faculty, Emory Department of Sociology and the Atlanta Site Lead (joint appointment with the Atlanta VA Medical Center), Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC); and Co-chair, Scientific Working Group on HIV and Aging, Center for AIDS Research at Emory University, Atlanta, Georgia, USA
| | - Marcia McDonnell Holstad
- Research Professor, Professor Emerita, and Marcia Stanhope Professor in Public Health, Nell Hodgson Woodruff School of Nursing; and Co-chair, Scientific Working Group on HIV and Aging, Center for AIDS Research at Emory University, Atlanta, Georgia, USA
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12
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Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Cheng S, Delling FN, Elkind MSV, Evenson KR, Ferguson JF, Gupta DK, Khan SS, Kissela BM, Knutson KL, Lee CD, Lewis TT, Liu J, Loop MS, Lutsey PL, Ma J, Mackey J, Martin SS, Matchar DB, Mussolino ME, Navaneethan SD, Perak AM, Roth GA, Samad Z, Satou GM, Schroeder EB, Shah SH, Shay CM, Stokes A, VanWagner LB, Wang NY, Tsao CW. Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association. Circulation 2021; 143:e254-e743. [PMID: 33501848 DOI: 10.1161/cir.0000000000000950] [Citation(s) in RCA: 2966] [Impact Index Per Article: 988.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2021 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors related to cardiovascular disease. RESULTS Each of the 27 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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13
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Dragović G, Andjić M, Toljić B, Jevtović D, Lukić R, de Luka S, Trbovich A, Milašin J. Correlation between metabolic syndrome and relative telomere length shortening in HIV/AIDS patients on combined antiretroviral therapy. Exp Gerontol 2021; 147:111269. [PMID: 33529748 DOI: 10.1016/j.exger.2021.111269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 12/20/2020] [Accepted: 01/29/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Components of the metabolic syndrome (MetS) play an important role in the accelerated aging process. Relative telomere length (RTL) is a marker of biological aging. The aim of our study was to determine RTL and its possible association with MetS and the components of MetS in HIV-infected patients treated with cART. METHODS We included 24 HIV-infected men, all Caucasians, with successful cART (<50 HIV-RNA copies/mL) and on stable cART for at least 24 months. The presence of MetS and its components was determined by the criteria prescribed by the International Diabetes Federation. RTL was determined by Real-Time PCR and ΔΔCt method. We performed a multiple linear regression modeling on log-transformed RTL (dependant variable) to evaluate which components of the metabolic syndrome as well as cART duration and cART type, had an impact on RTL. RESULTS Eleven (45.8%) patients had and 13 (54.2%) had not MetS. All patients, had an undetectable viral RNA and a relatively good immune status. The mean RTL was 0.62 ± 0.15 and 0.95 ± 0.36 in patients with and without MetS, respectively (p = 0.01). Multiple linear regression model showed no significant association between duration of cART, cART type and RTL (p = 0.2165, p = 0.8628, respectively). The same analysis showed that an increase in number of MetS components was associated with shorter telomere length (β = -0.4982, p = 0.042). CONCLUSIONS We showed for the first time association between RTL shortening in HIV-infected men with metabolic syndrome. Furthermore, our study also indicated that an increment of metabolic syndrome components is strongly associated with shorter telomere length.
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Affiliation(s)
- Gordana Dragović
- Department of Pharmacology, Clinical Pharmacology and Toxicology, School of Medicine, University of Belgrade, Belgrade, Serbia.
| | - Mladen Andjić
- Department of Pharmacology, Clinical Pharmacology and Toxicology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Boško Toljić
- Department of Human Genetics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Djordje Jevtović
- Infectious and Tropical Diseases Hospital, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Relja Lukić
- Obstetrics/Gynaecology Clinic "Narodni front", School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Silvio de Luka
- Institute of Pathological Physiology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Alexander Trbovich
- Institute of Pathological Physiology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Milašin
- Department of Human Genetics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
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14
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Keram A, Pei N, Qi T, Xun J, Gu Y, Li W. Untargeted GC/TOFMS unravel metabolic profiles in cerebrospinal fluid of Chinese people living with HIV. J Clin Lab Anal 2021; 35:e23673. [PMID: 33476447 PMCID: PMC7957991 DOI: 10.1002/jcla.23673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 10/06/2020] [Accepted: 10/30/2020] [Indexed: 12/24/2022] Open
Abstract
Background Metabolic syndrome becomes a focus of clinical cares to people living with HIV (PLHIV) globally. This study aimed to explore the metabolic profiles in cerebrospinal fluid (CSF) of Chinese people living with HIV (PLHIV). Methods Cerebrospinal fluid samples from PLHIV and healthy controls were collected from our hospital. Then, the metabolic profiles of CSFs were analyzed PLHIV with healthy individual as the normal controls using the untargeted GC/TOFMS. Following this, kyoto encyclopedia of genes and genomes annotation and pathway analysis were performed to further explore the underlying mechanism of these metabolic alterations in cognitive impairment of PLHIV. Results Both PCA analysis and OPLS‐DA had presented that most samples were localized in 95% CI and the gap between control and HIV could significantly separate from each other. Upon this quality control, a total of 82 known metabolites were identified in CSF between PLHIV and healthy controls. Clustering of these metabolites presented that these differentially expressed metabolites could markedly distinguish HIV from healthy controls. Further pathway analyses showed that TCA cycle (citric acid, fumaric acid, lactate, et al.), amino acid (arginine, proline, alanine, aspartate, glutamine, et al.), lipid (cholesterol, butyrate, et al.) metabolisms were significantly changed in CSF of PLHIV, which might affect the cognitive status of PLHIV via affecting neuron energy support, signaling transduction, and neuroinflammation. Conclusion Metabolic profiles were significantly altered in CSF and might play key roles in the etiology of cognitive impairment of PHLIV. Further explore the exact mechanism for these metabolic changes might be useful for cognitive impairment management of PHLIV.
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Affiliation(s)
- Alim Keram
- Department of Neurosurgery, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Ning Pei
- Department of Tuberculosis, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Tangkai Qi
- Department of Infection and Immunity, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Jingna Xun
- Department of Scientific Research Center, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Yutong Gu
- Department of Tuberculosis and Orthopaedics, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Wenwei Li
- Department of Neurology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
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15
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Calza L, Colangeli V, Borderi M, Beci G, Esposito F, Bon I, Re MC, Viale P. Rosuvastatin decreases serum inflammatory markers and slows atherosclerosis progression rate in treated HIV-infected patients with metabolic syndrome. Infect Dis (Lond) 2020; 53:81-88. [PMID: 32955957 DOI: 10.1080/23744235.2020.1823468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Metabolic syndrome (MetS) is usually associated in general population with systemic inflammation and higher cardiovascular risk, but data about the effect of statins in patients with HIV infection and MetS are lacking to date. METHODS Prospective cohort study of treated HIV-infected patients, aged from 40 to 60 years, with or without MetS, who started rosuvastatin (10 mg daily), and were followed-up for 12 months. The primary endpoint was change in serum levels of high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and tumour necrosis factor-α (TNF-α). The secondary endpoint was change in the carotid intima-media thickness (IMT). RESULTS One hundred and twenty-five patients were enrolled: 61 with MetS (MetS group) and 64 without MetS (control group). After 12 months, rosuvastatin produced a significant decrease in mean serum levels of hsCRP (-0.28 mg/dL; p = .037), IL-6 (-2.1 pg/mL; p = .018) and TNF-α (-6.3 pg/mL; p = .004) in patients with MetS. On the contrary, in controls rosuvastatin did not lead to a significant change in mean levels of all biomarkers. After 12 months, the mean IMT increase at the carotid bifurcation was significantly lower in the MetS group than in the control group at the carotid bifurcation (0.017 vs. 0.031 mm; p = .037) and in all other anatomical sites. CONCLUSION Our findings suggest that rosuvastatin is effective in reducing serum inflammation markers and slowing atherosclerosis progression rate in HIV-infected patients on cART and with MetS, while its effects on serum biomarkers and IMT increase seem to be negligible in those without MetS.
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Affiliation(s)
- Leonardo Calza
- Clinics of Infectious Diseases, 'Alma Mater Studiorum', University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Vincenzo Colangeli
- Clinics of Infectious Diseases, 'Alma Mater Studiorum', University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Marco Borderi
- Clinics of Infectious Diseases, 'Alma Mater Studiorum', University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Giacomo Beci
- Clinics of Infectious Diseases, 'Alma Mater Studiorum', University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Fabio Esposito
- Clinics of Infectious Diseases, 'Alma Mater Studiorum', University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Isabella Bon
- Unit of Microbiology, 'Alma Mater Studiorum', University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Maria Carla Re
- Unit of Microbiology, 'Alma Mater Studiorum', University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Pierluigi Viale
- Clinics of Infectious Diseases, 'Alma Mater Studiorum', University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
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16
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Masenga SK, Elijovich F, Koethe JR, Hamooya BM, Heimburger DC, Munsaka SM, Laffer CL, Kirabo A. Hypertension and Metabolic Syndrome in Persons with HIV. Curr Hypertens Rep 2020; 22:78. [PMID: 32880756 PMCID: PMC7467859 DOI: 10.1007/s11906-020-01089-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW With the advent of highly active antiretroviral therapy (ART), the life span of persons with HIV (PWH) has been nearly normalized. With aging, prevalence of the metabolic syndrome (MetS), including hypertension, has increased in the HIV population and exceeds that in the general population in some studies. This is due to a combination of traditional risk factors in addition to the effects attributable to the virus and ART. We review recent findings on the mechanisms contributing to MetS and hypertension in PWH, particularly those specific to the viral infection and to ART. RECENT FINDINGS Activation of the renin-angiotensin-aldosterone system (RAAS) and chronic immune activation contribute to the development of MetS and hypertension in PWH. HIV proteins and some ART agents alter adipocyte health contributing to dyslipidemias, weight gain, and insulin resistance. HIV infection also contributes to hypertension by direct effects on the RAAS that intertwine with inflammation by the RAAS also contributing to T cell activation. Recent data suggest that in addition to current ART, therapeutic targeting of the MetS and hypertension in PWH, by interfering with the RAAS, treating insulin resistance directly or by use of immunomodulators that dampen inflammation, may be critical for preventing or treating these risk factors and to improve overall cardiovascular complications in the HIV-infected aging population.
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Affiliation(s)
- Sepiso K Masenga
- HAND Research group, School of Medicine and Health Sciences, Mulungushi University, Livingstone, Zambia
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Fernando Elijovich
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - John R Koethe
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Benson M Hamooya
- HAND Research group, School of Medicine and Health Sciences, Mulungushi University, Livingstone, Zambia
- School of Public Health, University of Zambia, Lusaka, Zambia
| | - Douglas C Heimburger
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Internal Medicine, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Sody M Munsaka
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Cheryl L Laffer
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Annet Kirabo
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Room 536 Robinson Research Building, Nashville, TN, 37232-6602, USA.
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17
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Calza L, Colangeli V, Borderi M, Coladonato S, Tazza B, Bon I, Re MC, Viale P. Improvement in insulin sensitivity and serum leptin concentration after the switch from a ritonavir-boosted PI to raltegravir or dolutegravir in non-diabetic HIV-infected patients. J Antimicrob Chemother 2020; 74:731-738. [PMID: 30541118 DOI: 10.1093/jac/dky507] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 10/30/2018] [Accepted: 11/12/2018] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES An observational, prospective, cohort study was performed to assess changes in insulin sensitivity and serum leptin level after a switch from a ritonavir-boosted PI (PI/r) to raltegravir or dolutegravir in HIV-infected adults on stable combination ART (cART). METHODS Non-diabetic HIV-infected patients receiving suppressive cART including tenofovir disoproxil fumarate/emtricitabine plus one PI/r, who underwent a switch from the PI/r to raltegravir (group A) or dolutegravir (group B), were enrolled in the study. Serum levels of insulin, leptin and the homeostasis model assessment of insulin resistance (HOMA) index were evaluated during a 12 month follow-up. RESULTS Overall, 86 patients were enrolled: 45 patients were included in group A and 41 were included in group B. The mean age was 45.7 years and 74 (86%) patients were male. After 12 months of follow-up, a significant reduction in the mean concentration of leptin and insulin was reported both in group A [-0.61 ng/mL (P < 0.001) and -2.5 mIU/L (P = 0.008), respectively] and in group B [-0.54 ng/mL (P = 0.005) and -2.1 mIU/L (P = 0.017), respectively], without a significant difference between the groups. A significant and comparable reduction in the mean HOMA index was reported both in group A [-0.55 (P = 0.004)] and in group B [-0.49 (P < 0.001)], as well as a significant decrease in lipid levels. CONCLUSIONS In HIV-positive subjects on suppressive cART, the switch from a PI/r to raltegravir or dolutegravir led to a significant and comparable reduction in both HOMA index and serum leptin level, reflecting a similar and significant improvement in insulin sensitivity.
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Affiliation(s)
- Leonardo Calza
- Department of Medical and Surgical Sciences, Unit of Infectious Diseases, 'Alma Mater Studiorum' University of Bologna, S. Orsola-Malpighi Hospital, via Massarenti 11, Bologna, Italy
| | - Vincenzo Colangeli
- Department of Medical and Surgical Sciences, Unit of Infectious Diseases, 'Alma Mater Studiorum' University of Bologna, S. Orsola-Malpighi Hospital, via Massarenti 11, Bologna, Italy
| | - Marco Borderi
- Department of Medical and Surgical Sciences, Unit of Infectious Diseases, 'Alma Mater Studiorum' University of Bologna, S. Orsola-Malpighi Hospital, via Massarenti 11, Bologna, Italy
| | - Simona Coladonato
- Department of Medical and Surgical Sciences, Unit of Infectious Diseases, 'Alma Mater Studiorum' University of Bologna, S. Orsola-Malpighi Hospital, via Massarenti 11, Bologna, Italy
| | - Beatrice Tazza
- Department of Medical and Surgical Sciences, Unit of Infectious Diseases, 'Alma Mater Studiorum' University of Bologna, S. Orsola-Malpighi Hospital, via Massarenti 11, Bologna, Italy
| | - Isabella Bon
- Department of Specialistic, Diagnostic and Experimental Medicine, Unit of Microbiology, 'Alma Mater Studiorum' University of Bologna, S. Orsola-Malpighi Hospital, via Massarenti 9, Bologna, Italy
| | - Maria Carla Re
- Department of Specialistic, Diagnostic and Experimental Medicine, Unit of Microbiology, 'Alma Mater Studiorum' University of Bologna, S. Orsola-Malpighi Hospital, via Massarenti 9, Bologna, Italy
| | - Pierluigi Viale
- Department of Medical and Surgical Sciences, Unit of Infectious Diseases, 'Alma Mater Studiorum' University of Bologna, S. Orsola-Malpighi Hospital, via Massarenti 11, Bologna, Italy
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18
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Ergin HE, Inga EE, Maung TZ, Javed M, Khan S. HIV, Antiretroviral Therapy and Metabolic Alterations: A Review. Cureus 2020; 12:e8059. [PMID: 32537277 PMCID: PMC7286589 DOI: 10.7759/cureus.8059] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The introduction of antiretroviral therapy (ART) has caused some metabolic problems to people who suffer from HIV. ART probably is not the sole reason for these metabolic disorders. Most likely, HIV itself affects the metabolism as well. We conducted research to find the prevalence of the different types of metabolic disorders among HIV(+) patients. Female gender, high BMI, and older age are among the risk factors for the occurrence of metabolic disorders. Regarding dyslipidemia, hypertriglyceridemia and low high-density lipoproteins (HDLs) are the most common types of dyslipidemia in the studies we included. Protease inhibitors (PIs) are widely known as the most common class of antiretroviral drugs that cause metabolic disorders, and some studies in our review also demonstrated this knowledge. In our review, we concluded that HIV and ART concurrently alter the metabolism, but further research is required about this substantial topic.
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Affiliation(s)
- Huseyin Ekin Ergin
- Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Evelyn E Inga
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.,Internal Medicine, LaSante Health Center, Brooklyn, USA
| | - Tun Zan Maung
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Mehwish Javed
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Safeera Khan
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
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19
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Tagliari CFDS, de Oliveira CN, Vogel GM, da Silva PB, Linden R, Lazzaretti RK, Notti RK, Sprinz E, Mattevi VS. Investigation of SIRT1 gene variants in HIV-associated lipodystrophy and metabolic syndrome. Genet Mol Biol 2020; 43:e20190142. [PMID: 32106282 PMCID: PMC7198015 DOI: 10.1590/1678-4685-gmb-2019-0142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 11/21/2019] [Indexed: 01/17/2023] Open
Abstract
HIV-infected individuals on chronic use of highly active antiretroviral therapy (HAART) are more likely to develop adipose tissue and metabolic disorders, such as lipodystrophy (LD) and metabolic syndrome (MetS). The development of these phenotypes is known to be multifactorial. Thus, variants in genes implicated in adipogenesis and lipid metabolism may increase susceptibility to LD and MetS. Sirtuin 1 (SIRT1) may influence the outcome of these disturbances due to its role in the regulation of transcription factors involved in energy regulation. Therefore, we genotyped four polymorphisms located in SIRT1 (rs2273773 T>C, rs12413112 G>A, rs7895833 A>G, rs12049646 T>C) in 832 HIV-infected patients receiving HAART by real-time polymerase chain reaction. The prevalence of LD was 55.8% and MetS was 35.3%. Lipoatrophy was the most prevalent subtype in all samples (38.0%) and showed significant difference between white and non-white individuals (P = 0.002). None of the genetic variants investigated in SIRT1 was associated with LD and MetS. White individuals and those in longer time of HAART use were more likely to develop LD. We concluded that these SIRT1 polymorphisms are not predictive factors to the development of lipodystrophy and metabolic syndrome in HIV-infected individuals from Brazil.
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Affiliation(s)
| | - Cáren Nunes de Oliveira
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Laboratório de Biologia Molecular, Porto Alegre, RS, Brazil
| | - Greice Meyer Vogel
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Laboratório de Biologia Molecular, Porto Alegre, RS, Brazil
| | - Patrícia Baptista da Silva
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Laboratório de Biologia Molecular, Porto Alegre, RS, Brazil
| | - Rafael Linden
- Universidade Feevale, Instituto de Ciências da Saúde, Laboratório de Toxicologia Analítica, Novo Hamburgo, RS, Brazil
| | - Rosmeri Kuhmmer Lazzaretti
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Departamento de Doenças Infecciosas, Porto Alegre, RS, Brazil
| | - Regina Kuhmmer Notti
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Departamento de Doenças Infecciosas, Porto Alegre, RS, Brazil
| | - Eduardo Sprinz
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Departamento de Doenças Infecciosas, Porto Alegre, RS, Brazil
| | - Vanessa Suñé Mattevi
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Laboratório de Biologia Molecular, Porto Alegre, RS, Brazil
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20
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Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Shay CM, Spartano NL, Stokes A, Tirschwell DL, VanWagner LB, Tsao CW. Heart Disease and Stroke Statistics-2020 Update: A Report From the American Heart Association. Circulation 2020; 141:e139-e596. [PMID: 31992061 DOI: 10.1161/cir.0000000000000757] [Citation(s) in RCA: 4715] [Impact Index Per Article: 1178.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports on the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2020 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, metrics to assess and monitor healthy diets, an enhanced focus on social determinants of health, a focus on the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors, implementation strategies, and implications of the American Heart Association's 2020 Impact Goals. RESULTS Each of the 26 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, healthcare administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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21
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Barceló C, Guidi M, Thorball CW, Hammer C, Chaouch A, Scherrer AU, Hasse B, Cavassini M, Furrer H, Calmy A, Haubitz S, Bernasconi E, Buclin T, Fellay J, Tarr PE, Csajka C. Impact of Genetic and Nongenetic Factors on Body Mass Index and Waist-Hip Ratio Change in HIV-Infected Individuals Initiating Antiretroviral Therapy. Open Forum Infect Dis 2020; 7:ofz464. [PMID: 31988971 PMCID: PMC6974740 DOI: 10.1093/ofid/ofz464] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 01/20/2020] [Indexed: 12/17/2022] Open
Abstract
Objective There is limited data on abdominal obesity and the influence of genetics on weight change after antiretroviral therapy (ART) initiation. We assessed body mass index (BMI) and waist hip ration (WHR) change over time in the Swiss HIV Cohort study (SHCS). Methods Mixed-effects models characterizing BMI and WHR change over time in 1090 SHCS participants initiating ART between 2005 and 2015 were developed and used to quantify the influence of demographics, clinical factors, and genetic background. Results Individuals with CD4 nadir <100 cells/µL gained 6.4 times more BMI than individuals with ≥200, and 2.8 times more WHR than individuals with ≥100 (P < .001) during the first 1.5 and 2.5 years after ART initiation, respectively. The risk of being overweight or obese after 1.5 years increased with CD4 nadir <100 cells/µL compared to 100–199 (odds ratio [OR], 2.07; 95% confidence interval [CI], 1.63–2.74) and ≥200 (OR, 1.69; 95% CI, 1.26–2.32), persisting after 10 years of ART. The risk of abdominal obesity after 2.5 years increased with CD4 nadir <100 compared to ≥100 (OR, 1.35; 95% CI, 1.17–1.54 [in men]; OR, 1.36; 95% CI, 1.18–1.57 [in women]), persisting after 10 years of ART. No significant differences were found across antiretroviral drug classes or genetic scores. Conclusions The risk of general and abdominal obesity increased with CD4 nadir <100 cells/µL. Based on our results, including the genetic background would not improve obesity predictions in HIV-infected individuals.
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Affiliation(s)
- Catalina Barceló
- Center for Research and Innovation in Clinical Pharmaceutical Sciences, Institute of Pharmaceutical Sciences of Western Switzerland, University of Lausanne, Lausanne, Switzerland
| | - Monia Guidi
- Center for Research and Innovation in Clinical Pharmaceutical Sciences, Institute of Pharmaceutical Sciences of Western Switzerland, University of Lausanne, Lausanne, Switzerland.,Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Christian W Thorball
- School of Life Sciences, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.,Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Christian Hammer
- Department of Cancer Immunology, Genentech, South San Francisco, CA, USA.,Department of Human Genetics, Genentech, South San Francisco, CA, USA
| | - Aziz Chaouch
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Switzerland
| | | | - Barbara Hasse
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Matthias Cavassini
- Service of Infectious Diseases, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Hansjakob Furrer
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Switzerland
| | - Alexandra Calmy
- Division of Infectious Diseases, HIV/AIDS Unit, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Sebastian Haubitz
- Department of Infectious Diseases and Hospital Hygiene, Kantonsspital Aarau, Switzerland
| | - Enos Bernasconi
- Division of Infectious Diseases, Regional Hospital, Lugano, Switzerland
| | - Thierry Buclin
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Jacques Fellay
- School of Life Sciences, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.,Swiss Institute of Bioinformatics, Lausanne, Switzerland.,Precision Medicine Unit, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Philip E Tarr
- University Department of Medicine, Infectious Diseases Service, Kantonsspital Baselland, University of Basel, Switzerland
| | - Chantal Csajka
- Center for Research and Innovation in Clinical Pharmaceutical Sciences, Institute of Pharmaceutical Sciences of Western Switzerland, University of Lausanne, Lausanne, Switzerland.,School of Pharmaceutical Sciences, Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
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22
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Moulignier A, Costagliola D. Metabolic Syndrome and Cardiovascular Disease Impacts on the Pathophysiology and Phenotype of HIV-Associated Neurocognitive Disorders. Curr Top Behav Neurosci 2020; 50:367-399. [PMID: 31989463 DOI: 10.1007/7854_2019_123] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Evidence from epidemiological studies on the general population suggests that midlife cardiovascular disease (CVD) and/or metabolic syndrome (MetS) are associated with an increased risk of cognitive impairment and dementia later in life. In the modern combined antiretroviral therapy (cART) era, as in the general population, CVD and MetS were strongly and independently associated with poorer cognitive performances of sustained immunovirologically controlled persons living with human immunodeficiency viruses (PLHIVs). Those findings suggest that CV/metabolic comorbidities could be implicated in the pathogenesis of HIV-associated neurocognitive disorders (HAND) and might be more important than factors related to HIV infection or its treatment, markers of immunocompetence, or virus replication. The association between CVD/MetS and cognition decline is driven by still not well-understood mechanisms, but risk might well be the consequence of increased brain inflammation and vascular changes, notably cerebral small-vessel disease. In this review, we highlight the correspondences observed between the findings concerning CVD and MetS in the general population and virus-suppressed cART-treated PLHIVs to evaluate the real brain-aging processes. Indeed, incomplete HIV control mainly reflects HIV-induced brain damage described during the first decades of the pandemic. Given the growing support that CVD and MetS are associated with HAND, it is crucial to improve early detection and assure appropriate management of these conditions.
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Affiliation(s)
- Antoine Moulignier
- Department of Neurology, Memory Clinic, Fondation Adolphe de Rothschild, Paris, France.
| | - Dominique Costagliola
- INSERM, Sorbonne Université, Institut Pierre-Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France.
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23
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Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Das SR, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Jordan LC, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, O'Flaherty M, Pandey A, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Spartano NL, Stokes A, Tirschwell DL, Tsao CW, Turakhia MP, VanWagner LB, Wilkins JT, Wong SS, Virani SS. Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation 2019; 139:e56-e528. [PMID: 30700139 DOI: 10.1161/cir.0000000000000659] [Citation(s) in RCA: 5216] [Impact Index Per Article: 1043.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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24
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Jaworowski A, Hearps AC, Angelovich TA, Hoy JF. How Monocytes Contribute to Increased Risk of Atherosclerosis in Virologically-Suppressed HIV-Positive Individuals Receiving Combination Antiretroviral Therapy. Front Immunol 2019; 10:1378. [PMID: 31275317 PMCID: PMC6593090 DOI: 10.3389/fimmu.2019.01378] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 05/31/2019] [Indexed: 12/27/2022] Open
Abstract
Combination antiretroviral therapy (ART) is effective at suppressing HIV viremia to achieve persistently undetectable levels in peripheral blood in the majority of individuals with access and ability to maintain adherence to treatment. However, evidence suggests that ART is less effective at eliminating HIV-associated inflammation and innate immune activation. To the extent that residual inflammation and immune activation persist, virologically suppressed people living with HIV (PLWH) may have increased risk of inflammatory co-morbidities, and adjunctive therapies may need to be considered to reduce HIV-related inflammation and fully restore the health of virologically suppressed HIV+ individuals. Cardiovascular disease (CVD) is the single leading cause of death in the developed world and is becoming more important in PLWH with access to ART. Arterial disease due to atherosclerosis, leading to acute myocardial infarction (AMI) and stroke, is a major component of CVD. Atherosclerosis is an inflammatory disease, and epidemiological comparisons of atherosclerosis and AMI show a higher prevalence and suggest a greater risk in PLWH compared to the general population. The reasons for greater prevalence of CVD in PLWH can be broadly grouped into four categories: (a) the higher prevalence of traditional risk factors e.g., smoking and hypertension (b) dyslipidemia (also a traditional risk factor) caused by off-target effects of ART drugs (c) HIV-related inflammation and immune activation and (d) other undefined HIV-related factors. Management strategies aimed at reducing the impact of traditional risk factors in PLWH are similar to those for the general population and their effectiveness is currently being evaluated. Together with improvements in ART regimens and guidelines for treatment, and a greater awareness of its impact on CVD, the HIV-related risk of AMI and stroke is decreasing but remains elevated compared to the general community. Monocytes are key effector cells which initiate the formation of atherosclerotic plaques by migrating into the intima of coronary arteries and accumulating as foam cells full of lipid droplets. This review considers the specific role of monocytes as effector cells in atherosclerosis which progresses to AMI and stroke, and explores mechanisms by which HIV may promote an atherogenic phenotype and function independent of traditional risk factors. Altered monocyte function may represent a distinct HIV-related factor which increases risk of CVD in PLWH.
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Affiliation(s)
- Anthony Jaworowski
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia.,Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, VIC, Australia.,Life Sciences Discipline, Burnet Institute, Melbourne, VIC, Australia
| | - Anna C Hearps
- Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, VIC, Australia.,Life Sciences Discipline, Burnet Institute, Melbourne, VIC, Australia
| | - Thomas A Angelovich
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia.,Life Sciences Discipline, Burnet Institute, Melbourne, VIC, Australia
| | - Jennifer F Hoy
- Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, VIC, Australia
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25
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Zhao D, Ding Y, Lin H, Chen X, Shen W, Gao M, Wei Q, Zhou S, Liu X, He N. Mitochondrial Haplogroups N9 and G Are Associated with Metabolic Syndrome Among Human Immunodeficiency Virus-Infected Patients in China. AIDS Res Hum Retroviruses 2019; 35:536-543. [PMID: 30950284 DOI: 10.1089/aid.2018.0151] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Increasing evidence shows that mitochondrial DNA (mtDNA) variations have an important effect on metabolic disorders, but such studies have not been conducted in HIV-infected patients in Asia. We investigated the distribution of mtDNA haplogroups and their correlation with metabolic disorders in HIV-infected patients. A cross-sectional survey was performed among 296 HIV patients older than the age of 40 years in a rural prefecture, Eastern China. The entire mtDNA sequence was amplified by polymerase chain reaction using four overlapping pairs of primers that have been standardly used. In this sample, mtDNA haplogroups B, D, M7, and F were the most dominant haplogroups. The overall prevalence of metabolic syndrome (MetS) was 36.1%, and was highest (77.8%) among those with haplogroup G and lowest (21.4%) among those with haplogroup M8. In multivariable analysis, haplogroups G and N9 were significantly associated with the presence of MetS [adjusted odds ratio (aOR) = 13.5, 95% confidence interval (CI): 1.9-94.7; aOR = 8.1, 95% CI: 1.8-36.1; respectively]. Moreover, patients with haplogroup G had increased odds of elevated glycated hemoglobin (HbA1c) (aOR = 10.1, 95% CI: 1.4-71.1), patients with haplogroup N9 had increased odds of elevated triglycerides (aOR = 13.5, 95% CI: 2.4-76.8). No significant association between mtDNA haplogroups and other MetS components was observed. Our data demonstrate the association between mtDNA haplogroups and MetS in HIV-infected patients. The Asian-specific mtDNA haplogroups G and N9 may confer higher risk for the development of MetS in HIV-infected patients, which requires further longitudinal investigation.
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Affiliation(s)
- Dan Zhao
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
- Key Laboratory of Health Technology Assessment of Ministry of Health, Fudan University, Shanghai, China
| | - Yingying Ding
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Haijiang Lin
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
- Taizhou City Center for Disease Control and Prevention, Taizhou, China
| | - Xiaoxiao Chen
- Taizhou City Center for Disease Control and Prevention, Taizhou, China
| | - Weiwei Shen
- Taizhou City Center for Disease Control and Prevention, Taizhou, China
| | - Meiyang Gao
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Qian Wei
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Sujuan Zhou
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Xing Liu
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Na He
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
- Key Laboratory of Health Technology Assessment of Ministry of Health, Fudan University, Shanghai, China
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26
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Coronel-Castillo CE, Qi X, Contreras-Carmona J, Ramírez-Pérez OL, Méndez-Sánchez N. Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis in HIV infection: a metabolic approach of an infectious disease. Expert Rev Gastroenterol Hepatol 2019; 13:531-540. [PMID: 30905208 DOI: 10.1080/17474124.2019.1599284] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
With the successes of antiretroviral therapy, patients infected with human immunodeficiency virus (HIV) living longer. Regarding this, the common diseases of HIV population (i.e., opportunistic infections) are now losing ground in front of metabolic alterations. This phenomenon is related to the delay in progression to acquired immune deficiency syndrome (AIDS), making it so that patients live in a chronic inflammatory state which, combined with other mechanisms such infectious ones, cause metabolic diseases. Areas covered: Considering a high prevalence of metabolic alterations, the relationship between metabolic syndrome (MetS) with nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), and liver diseases as a major cause of death in the HIV-infected population, this paper aims to overview the mechanisms and prevalence of NAFLD and NASH as they relate to the developed metabolic diseases of HIV patients. Expert opinion: The pathways underlying MetS include the effects of HIV and ART on the liver, adipose tissue, and muscle. These mechanisms result in liver damage, consequently leading to NAFLD and its more severe form NASH. These conditions have increased in HIV-infected population in recent years and since their life expectancy is improving it is important to be ready to attend their new emerging diseases.
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Affiliation(s)
| | - Xingshun Qi
- b Department of Gastroenterology , General Hospital of Shenyang Military Area , Shenyang , China
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27
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Low H, Hoang A, Pushkarsky T, Dubrovsky L, Dewar E, Di Yacovo MS, Mukhamedova N, Cheng L, Downs C, Simon G, Saumoy M, Hill AF, Fitzgerald ML, Nestel P, Dart A, Hoy J, Bukrinsky M, Sviridov D. HIV disease, metabolic dysfunction and atherosclerosis: A three year prospective study. PLoS One 2019; 14:e0215620. [PMID: 30998801 PMCID: PMC6472799 DOI: 10.1371/journal.pone.0215620] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 04/04/2019] [Indexed: 12/19/2022] Open
Abstract
HIV infection is known to be associated with cardiometabolic abnormalities; here we investigated the progression and causes of these abnormalities. Three groups of participants were recruited: HIV-negative subjects and two groups of treatment-naïve HIV-positive subjects, one group initiating antiretroviral treatment, the other remaining untreated. Intima-media thickness (cIMT) increased in HIV-positive untreated group compared to HIV-negative group, but treatment mitigated the difference. We found no increase in diabetes-related metabolic markers or in the level of inflammation in any of the groups. Total cholesterol, low density lipoprotein cholesterol and apoB levels were lower in HIV-positive groups, while triglyceride and Lp(a) levels did not differ between the groups. We found a statistically significant negative association between viral load and plasma levels of total cholesterol, LDL cholesterol, HDL cholesterol, apoA-I and apoB. HIV-positive patients had hypoalphalipoproteinemia at baseline, and we found a redistribution of sub-populations of high density lipoprotein (HDL) particles with increased proportion of smaller HDL in HIV-positive untreated patients, which may result from increased levels of plasma cholesteryl ester transfer protein in this group. HDL functionality declined in the HIV-negative and HIV-positive untreated groups, but not in HIV-positive treated group. We also found differences between HIV-positive and negative groups in plasma abundance of several microRNAs involved in lipid metabolism. Our data support a hypothesis that cardiometabolic abnormalities in HIV infection are caused by HIV and that antiretroviral treatment itself does not influence key cardiometabolic parameters, but mitigates those affected by HIV.
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Affiliation(s)
- Hann Low
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Anh Hoang
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Tatiana Pushkarsky
- Department of Microbiology, Immunology and Tropical Diseases, George Washington University, Washington, DC, United States of America
| | - Larisa Dubrovsky
- Department of Microbiology, Immunology and Tropical Diseases, George Washington University, Washington, DC, United States of America
| | - Elizabeth Dewar
- The Heart Centre, Alfred Hospital, Melbourne, VIC, Australia
| | - Maria-Silvana Di Yacovo
- HIV and STD Unit, Infectious Disease Service, Hospital Universitari de Bellvitge, Instituto de Investigación Biomédica de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | | | - Lesley Cheng
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, VIC, Australia
| | - Catherine Downs
- Department of Infectious Diseases, Alfred Hospital, Melbourne, VIC, Australia
| | - Gary Simon
- Division of Infectious Diseases, Department of Medicine, George Washington University, Washington, DC, United States of America
| | - Maria Saumoy
- HIV and STD Unit, Infectious Disease Service, Hospital Universitari de Bellvitge, Instituto de Investigación Biomédica de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Andrew F. Hill
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, VIC, Australia
| | - Michael L. Fitzgerald
- Lipid Metabolism Unit, Centre for Computational and Integrative Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Paul Nestel
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Anthony Dart
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- The Heart Centre, Alfred Hospital, Melbourne, VIC, Australia
| | - Jennifer Hoy
- Department of Infectious Diseases, Alfred Hospital, Melbourne, VIC, Australia
- Department of Medicine, Monash University, Melbourne, VIC, Australia
| | - Michael Bukrinsky
- Department of Microbiology, Immunology and Tropical Diseases, George Washington University, Washington, DC, United States of America
| | - Dmitri Sviridov
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- * E-mail:
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28
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CD4/CD8 Ratio as a Predictor for the Occurrence of Metabolic Syndrome in HIV / AIDS Patients During 6 Months of cART Therapy. J Med Biochem 2019; 38:489-495. [PMID: 31496914 PMCID: PMC6708296 DOI: 10.2478/jomb-2018-0049] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 12/17/2018] [Indexed: 12/18/2022] Open
Abstract
Background HIV infection is characterized by progressive depletion of CD4+ T cells due to their reduced synthesis and increased destruction followed by marked activation and expansion of CD8+ T lymphocytes. CD4/CD8 ratio was traditionally described as a marker of immune system ageing in the general population, but it increasingly appears as a marker of different outcomes in the HIV-infected population. The main objective of this study is to examine the power of CD4/CD8 ratio in predicting the occurrence of metabolic syndrome (MetS) in HIV-positive patients receiving cART therapy. Methods 80 HIV/AIDS subjects were included in a retrospective case-control study. Flow cytometry was used to determine the percentage of CD4+ and CD8+ cells in peripheral blood of these patients. The values of biochemical parameters (triglycerides, HDL, blood sugar, blood counts), immunological parameters (CD4/CD8, PCR), anthropometric measurements and type of cART therapy were evaluated in this study. Results After six months of cART therapy 19 (23.8%) subjects had all the elements necessary for making the diagnosis of MetS. Using multivariate analysis CD4/CD8 ratio was statistically significant (p < 0.05) and had the largest effect on development of MetS (Wald = 9.01; OR = 0.45), followed by cART (Wald = 7.87; OR = 0.10) and triglycerides (Wald = 5.27; OR = 1.7). On the other hand, body weight and waist circumference showed no statistically significant effect on the development of MetS after six months of cART, p > 0.05. Conclusions CD4/CD8 ratio proved to be a significant marker for prediction of metabolic syndrome in HIV/AIDS patients.
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29
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Abstract
PURPOSE OF REVIEW This review describes what is known concerning the burden of hypertension among people living with HIV (PLHIV), and also addresses relevant topics with respect to its risk factors and clinical management. RECENT FINDINGS Hypertension is highly prevalent in HIV-positive populations, and may be more common than in HIV-negative populations. Risk factors contributing to the development of hypertension in PLHIV include demographic factors, genetic predisposition, lifestyle, comorbidities such as obesity, antiretroviral therapy-related changes in body composition, and potentially also immunodeficiency, immune activation and inflammation, as well as effects from antiretroviral therapy itself. Clinical management of hypertension in PLHIV requires awareness for drug-drug interactions between antiretroviral drugs and antihypertensive drugs. Awareness, treatment, and control of hypertension in PLHIV is currently suboptimal and should be improved. SUMMARY The burden of hypertension among PLHIV is high and its pathophysiology most likely multifactorial. Elucidating the exact pathophysiology of hypertension in PLHIV is vital as this may provide new targets to impact and improve clinical management. In the meantime, efforts should be made to improve hypertension management as per existing clinical guidelines in order to safeguard cardiovascular health and quality of life in PLHIV.
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Dragović G, Srdić D, Al Musalhi K, Soldatović I, Kušić J, Jevtović D, Nair D. Higher Levels of Cystatin C in HIV/AIDS Patients with Metabolic Syndrome. Basic Clin Pharmacol Toxicol 2017; 122:396-401. [PMID: 29024496 DOI: 10.1111/bcpt.12919] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 10/04/2017] [Indexed: 01/01/2023]
Abstract
Data about Cystatin-C levels in HIV-infected patients with metabolic syndrome (MetS) are still limited. Therefore, the aim of this study was to evaluate the possible correlations of serum levels of Cystatin-C in HIV/AIDS patients treated with combined antiretroviral therapy (cART) with or without MetS. This cross-sectional study included 89 HIV/AIDS Caucasian patients receiving cART at the HIV/AIDS Centre Belgrade, Serbia, divided into two groups according to the presence of MetS. Cystatin-C and other biochemical parameters were measured using Cytokine-Array-I, Metabolic-Array-I and Metabolic-Array-II, at the Department of Clinical Biochemistry, Royal Free Hospital and University College London, UK. A linear regression model was performed to evaluate which clinical and laboratory variables had an independent effect on Cystatin-C levels in HIV/AIDS patients. There were 33 (37%) patients with MetS and 56 (63%) without MetS. Patients with and without MetS were homogenous for age, duration of cART, number of cART combinations and CD4+ T cell count. Statistically increased Cystatin-C levels were observed in HIV/AIDS patients with MetS (p = 0.017), when compared to patients without MetS. Data showed a positive correlation of Cystatin-C and C-reactive protein (r = 0.349, p = 0.001). Using linear regression modelling, significant correlations were obtained between Cystatin-C and MetS in univariate analysis (p < 0.001). Cystatin-C levels were significantly higher in HIV/AIDS patients with MetS versus without MetS. Early assessment of MetS using Cystatin-C as a marker may ultimately help increase the lifespan of HIV/AIDS patients, as these patients appear to be at high risk of cardiovascular diseases.
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Affiliation(s)
- Gordana Dragović
- Department of Pharmacology, Clinical Pharmacology and Toxicology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Danica Srdić
- Department of Pharmacology, Clinical Pharmacology and Toxicology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Khawla Al Musalhi
- Department of Clinical Biochemistry, Royal Free Hospital and University College London, London, UK
| | - Ivan Soldatović
- Institute for Biomedical Statistics, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jovana Kušić
- Infectious and Tropical Diseases Hospital, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Djordje Jevtović
- Infectious and Tropical Diseases Hospital, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Devaki Nair
- Department of Clinical Biochemistry, Royal Free Hospital and University College London, London, UK
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