scholarly journals Standardized Comparison of Cardiovascular Risk Factors Prevalence in Spanish Women and Men Living with HIV and in the General Population

2021 ◽  
Vol 11 (11) ◽  
pp. 1085
Author(s):  
Anna Camps-Vilaró ◽  
Silvia Pérez-Fernández ◽  
Isaac Subirana ◽  
Ramon Teira ◽  
Vicente Estrada ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Population ◽  
Direct Method ◽  
Age Groups ◽  
People Living With Hiv ◽  
Population Cohort ◽  
Increased Risk ◽  
Significant Difference ◽  
General Population Cohort ◽  
Living With Hiv

People living with HIV (PLWH) have an increased risk of cardiovascular (CV) disease, likely due to a higher prevalence of CV risk factors. We compared the age-standardized prevalence and management of CV risk factors in PLWH to that of the general population in Spain. Blood pressure, lipid, glucose, and anthropometric profiles were cross-sectionally compared along with the treatment of hypertension, dyslipidemia, and diabetes in a general population cohort and a PLWH cohort. Prevalence rates were standardized by the direct method by 10-year age groups in European standard populations and stratified by gender. We included 47,593 individuals aged 35 to 74 years, 28,360 from the general population cohort and 19,233 from the PLWH cohort. Compared to the general population, PLWH had a higher concentration of triglycerides (>35 mg/dL in women and >26 mg/dL in men) and a higher prevalence of smoking (>23% and >17%) and diabetes (>9.9% and >8.5%). The prevalence of treated diabetes, hypertension, and dyslipidemia were up to three-fold lower in both women and men living with HIV. There was a significant difference in PLWH compared to the general population in the lipid, glucose, and anthropometric profile. In addition, PLWH were less often treated for diagnosed diabetes, hypertension, and dyslipidemia.

Standardized comparison of cardiovascular risk factors prevalence in Spanish women and men living with HIV and in the general population

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
A Camps-Vilaro ◽  
S Perez-Fernandez ◽  
R Teira ◽  
V Estrada ◽  
P Domingo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Risk Factor ◽  
General Population ◽  
Density Lipoprotein ◽  
P Value ◽  
People Living With Hiv ◽  
General Population Cohort ◽  
History Of ◽  
Living With Hiv

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Spain’s Ministry of Science and Innovation (Madrid, Spain), co-financed with European Union European Regional Development Funds –ERDF- [CIBERCV CB16/11/00229]; the Health Department of the Generalitat de Catalunya (Barcelona, Spain) through the Agència de Gestió d’Ajuts Universitaris de Recerca de Catalunya (AGAUR) (Barcelona, Spain) [2017SGR222]. OnBehalf DARIOS and VACH investigators Background People living with HIV (PLWH) have an increased risk of cardiovascular (CV) disease, likely due to a higher prevalence of CV risk factors. We compared age-standardized prevalence and management of CV risk factors in PLWH to that of general population in Spain. Methods Blood pressure, lipid, glucose and anthropometric profile were cross-sectionally compared along with treatment of hypertension, dyslipidemia, and diabetes in a general population cohort and a PLWH cohort. Prevalence rates were standardized by the direct method by 10-year age groups in European standard populations by gender.  Results We included 39,598 individuals aged 35 to 74 years: 28,360 from the general population cohort and 11,238 from the PLWH cohort. Compared to general population, PLWH had a higher concentration of triglycerides (>35mg/dL in women and >26mg/dL in men), and a higher prevalence of metabolic syndrome (>10% and >7.8%) and diabetes (>8.5% and >5.3%) (Table). The proportion of treated diabetes, dyslipidemia, and hypertension were up to 3-fold lower in both women and men living with HIV than in general population (Table). Conclusions Lipid, gluco-metabolic profiles were significantly worse in PLWH compared to general population. In addition, PLWH were less often treated for diagnosed diabetes, dyslipidemia, and hypertension. CV risk factor standardized prevalence Cardiovascular risk factor WOMEN MEN General population People living with HIV p-Value General population People living with HIV p-Value N = 15,159 N = 2,171 N = 13,201 N = 9,067 Hypertension, % 27.4 (26.7 - 28.0) 24.8 (21.6 - 28.1) 0.136 29.0 (28.2 - 29.7) 22.9 (21.4 - 24.4) <0.001 Treated hypertension, % a 62.7 (60.7 - 64.7) 18.9 (13.5 - 24.4) <0.001 59.3 (57.5 - 61.1) 24.1 (21.0 - 27.1) <0.001 Triglycerides, mg/dL b 99 (99 - 100) 134 (134 - 148) <0.001 122 (121 - 122) 148 (148 - 164) <0.001 Total cholesterol, mg/dL 214 (213 - 215) 207 (199 - 215) 0.111 214 (213 - 216) 195 (191 - 198) <0.001 Treated dyslipidaemia, % c 14.0 (13.5 - 14.6) 7.80 (5.60 - 10.0) <0.001 15.1 (14.5 - 15.7) 7.8 (6.8 - 8.7) <0.001 Glucose, mg/dL 97 (96 - 97) 103 (98 - 107) 0.007 104 (103 - 105) 106 (104 - 109) 0.122 Diabetes, % 10.6 (10.1 - 11.1) 19.1 (16.0 - 22.1) <0.001 15.4 (14.8 - 16.0) 20.7 (19.2 - 22.2) <0.001 Treated diabetes, % d 34.4 (31.5 - 37.2) 12.8 (8.00 - 17.5) <0.001 40.0 (37.1 - 42.9) 16.6 (13.9 - 19.3) <0.001 Metabolic Syndrome, % 20.5 (19.8 - 21.1) 31.1 (25.8 - 36.4) <0.001 27.9 (27.1 - 28.7) 35.7 (33.1 - 38.2) <0.001 Values are expressed as mean (95% confidence interval). a Among patients with history of hypertension. b Mean (95% confidence interval) were obtained with log-transformed values. c Among all cohort participants. d Among patients with history of diabetes. HDL-c, high density lipoprotein cholesterol; LDL-c, low density lipoprotein cholesterol

scholarly journals Rates and risk factors for suicidal ideation, suicide attempts and suicide deaths in persons with HIV: a systematic review and meta-analysis

2021 ◽  
Vol 34 (2) ◽  
pp. e100247
Author(s):  
Matt Pelton ◽  
Matt Ciarletta ◽  
Holly Wisnousky ◽  
Nicholas Lazzara ◽  
Monica Manglani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Suicidal Ideation ◽  
General Population ◽  
Suicide Attempts ◽  
Advanced Disease ◽  
Meta Analysis ◽  
People Living With Hiv ◽  
Meta Regression ◽  
Living With Hiv

BackgroundPeople living with HIV/AIDS (PLWHA) must contend with a significant burden of disease. However, current studies of this demographic have yielded wide variations in the incidence of suicidality (defined as suicidal ideation, suicide attempt and suicide deaths).AimsThis systematic review and meta-analysis aimed to assess the lifetime incidence and prevalence of suicidality in PLWHA.MethodsPublications were identified from PubMed (MEDLINE), SCOPUS, OVID (MEDLINE), Joanna Briggs Institute EBP and Cochrane Library databases (from inception to before 1 February 2020). The search strategy included a combination of Medical Subject Headings associated with suicide and HIV. Researchers independently screened records, extracted outcome measures and assessed study quality. Data were pooled using a random-effects model. Subgroup and meta-regression analyses were conducted to explore the associated risk factors and to identify the sources of heterogeneity. Main outcomes were lifetime incidence of suicide completion and lifetime incidence and prevalence of suicidal ideation and suicide attempt.ResultsA total of 185 199 PLWHA were identified from 40 studies (12 cohorts, 27 cross-sectional and 1 nested case-control). The overall incidence of suicide completion in PLWHA was 10.2/1000 persons (95%CI: 4.5 to 23.1), translating to 100-fold higher suicide deaths than the global general population rate of 0.11/1000 persons. The lifetime prevalence of suicide attempts was 158.3/1000 persons (95%CI: 106.9 to 228.2) and of suicidal ideation was 228.3/1000 persons (95%CI: 150.8 to 330.1). Meta-regression revealed that for every 10-percentage point increase in the proportion of people living with HIV with advanced disease (AIDS), the risk of suicide completion increased by 34 per 1000 persons. The quality of evidence by Grading of Recommendations, Assessment, Development and Evaluations for the suicide deaths was graded as ‘moderate’ quality.ConclusionsThe risk of suicide death is 100-fold higher in people living with HIV than in the general population. Lifetime incidence of suicidal ideation and attempts are substantially high. Suicide risk assessments should be a priority in PLWHA, especially for those with more advanced disease.

scholarly journals Prevalence and risk factors of pulmonary hypertension among adult patients with HIV infection in Ethiopia

2020 ◽  
Vol 10 (4) ◽  
pp. 204589402097151
Author(s):  
Dawit Kebede Huluka ◽  
Desalew Mekonnen ◽  
Sintayehu Abebe ◽  
Amha Meshesha ◽  
Dufera Mekonnen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Hypertension ◽  
Communicable Disease ◽  
Previous History ◽  
Systolic Pressure ◽  
Chronic Obstructive ◽  
Heart Catheterization ◽  
People Living With Hiv ◽  
Significant Difference ◽  
Living With Hiv

Globally, non-communicable diseases are increasing in people living with HIV. Pulmonary hypertension is a rare non-communicable disease in people living with HIV with a reported prevalence of <1%. However, data on pulmonary hypertension in people living with HIV from Africa are scarce and are non-existent from Ethiopia. This study aimed to examine the prevalence and severity of echocardiographic pulmonary hypertension and risk factors associated with pulmonary hypertension in people living with HIV in Ethiopia. A total of 315 consecutive adult people living with HIV followed at the Tikur Anbessa Specialized Hospital HIV Referral Clinic were enrolled from June 2018 to February 2019. Those with established pulmonary hypertension of known causes were excluded. A structured questionnaire was used to collect data on demographics, respiratory symptoms, physical findings, physician-diagnosed lung disease, and possible risk factors. Pulmonary hypertension was defined by a tricuspid regurgitant velocity of ≥2.9 m/sec on transthoracic echocardiography. A tricuspid regurgitant velocity ≥3.5, which translates into a pulmonary arterial pressure/right ventricular systolic pressure of ≥50 mmHg, was considered moderate-to-severe pulmonary hypertension. The mean age of the participants was 44.5 ± 9.8 years and 229 (72.7%) were females. Pulmonary hypertension was diagnosed in 44 (14.0%) of participants, of whom 9 (20.5%) had moderate-to-severe disease. In those with pulmonary hypertension, 17 (38.6%) were symptomatic: exertional dyspnea, cough, and leg swelling were seen in 12 (27.3%), 9 (20.5%), and 4 (9.1%), respectively. There was no significant difference in those with pulmonary hypertension compared to those without the disease by gender, cigarette smoking, previous history of pulmonary tuberculosis treatment, physician-diagnosed chronic obstructive pulmonary disease or bronchial asthma, duration of anti-retroviral therapy therapy or anti-retroviral regimen type. Pulmonary hypertension looks to be a frequent complication in people living with HIV in Ethiopia and is often associated with significant cardiopulmonary symptoms. Further studies using right heart catheterization are needed to better determine the etiology and prevalence of pulmonary hypertension in people living with HIV in Ethiopia compared to other countries.

scholarly journals Pattern of Glucose Tolerance among Patients with Peripheral Spondyloarthritis

2020 ◽  
Vol 5 (9) ◽  
pp. 773-777
Author(s):  
A T M Tanveer Hasan ◽  
Al-Mamun .
Keyword(s):  
Diabetes Mellitus ◽  
General Population ◽  
Glucose Tolerance ◽  
Inflammatory Diseases ◽  
Age Groups ◽  
Oral Glucose ◽  
Increased Risk ◽  
Significant Difference ◽  
Study Population ◽  
Peripheral Spondyloarthritis

Peripheral spondyloarthritis is a variant of spondyloarthritis which usually has a chronic course. There is an increased risk of cardiovascular diseases among patients with chronic inflammatory diseases in general. Coexisting diabetes mellitus can potentially add to the risk. The objective of this study was to determine the frequency of glucose intolerance in patients with spondyloarthritis The study was conducted among 35 participants with peripheral spondyloarthritis who visited the Department of Rheumatology, Enam Medical College & Hospital, Savar, Dhaka, Bangladesh from September, 2018 to January, 2020. The participants underwent either oral glucose tolerance test or estimation of HbA1C. The mean age of participants was 43.96 years. The majority (80%) of them were young to muddle-aged (≤40 years). 22.9% of the participants were prediabetic. Diabetes mellitus was found to be present in 37.1% of the participants. There was no significant difference between the study population and the general population in terms of frequency of prediabetes. But the frequency of diabetes in the study population was higher than that in the general population. There was no significant difference between males and females with regard to the frequencies of prediabetes and DM. Moreover, there was no significant difference in the frequencies of prediabetes and DM between young and middle-aged to elderly population. Considering the greater burden of DM among patients with peripheral spondyloarthritis across all age groups, routine screening for DM may be indicated in these individuals.

scholarly journals Endocrine and Metabolic Diseases Among Colorectal Cancer Survivors in a Population-Based Cohort

2019 ◽  
Vol 112 (1) ◽  
pp. 78-86
Author(s):  
Makenzie L Hawkins ◽  
Brenna E Blackburn ◽  
Kerry Rowe ◽  
John Snyder ◽  
Vikrant G Deshmukh ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factor ◽  
General Population ◽  
Metabolic Diseases ◽  
The United States ◽  
Population Cohort ◽  
Increased Risk ◽  
General Population Cohort ◽  
Time Periods

Abstract Background There are an estimated 1.4 million colorectal cancer (CRC) survivors in the United States. Research on endocrine and metabolic diseases over the long term in CRC survivors is limited. Obesity is a risk factor for CRC; thus it is of interest to investigate diseases that may share this risk factor, such as diabetes, for long-term health outcomes among CRC survivors. Methods A total of 7114 CRC patients were identified from the Utah Population Database and matched to a general population cohort of 25 979 individuals on birth year, sex, and birth state. Disease diagnoses (assessed over three time periods of 1–5 years, 5–10 years, and &gt;10 years) were identified using electronic medical records and statewide ambulatory and inpatient discharge data. Cox proportional hazard models were used to estimate the risk of endocrine and metabolic disease. Results Across all three time periods, risks for endocrine and metabolic diseases were statistically significantly greater for CRC survivors compared with the general population cohort. At 1–5 years postdiagnosis, CRC survivors’ risk for diabetes mellitus with complications was statistically significantly elevated (hazard ratio [HR] = 1.36, 99% confidence interval [CI] = 1.09 to 1.70). CRC survivors also experienced a 40% increased risk of obesity at 1–5 years postcancer diagnosis (HR= 1.40, 99% CI= 1.66 to 2.18) and a 50% increased risk at 5–10 years postdiagnosis (HR = 1.50, 99% CI= 1.16 to 1.95). Conclusions Endocrine and metabolic diseases were statistically significantly higher in CRC survivors throughout the follow-up periods of 1–5 years, 5–10 years, and more than 10 years postdiagnosis. As the number of CRC survivors increases, understanding the long-term trajectory is critical for improved survivorship care.

scholarly journals Immunogenicity of the Ad26.CoV2.S vaccine in people living with HIV

2021 ◽  
Author(s):  
Khadija Khan ◽  
Gila Lustig ◽  
Mallory Bernstein ◽  
Derseree Archary ◽  
Sandile Cele ◽  
...  
Keyword(s):  
South African ◽  
Neutralizing Antibodies ◽  
People Living With Hiv ◽  
Open Label ◽  
Live Virus ◽  
Neutralization Capacity ◽  
Risk Of Death ◽  
Increased Risk ◽  
Significant Difference ◽  
Living With Hiv

Background People living with HIV (PLWH) have been reported to have an increased risk of more severe Covid-19 disease outcome and an increased risk of death relative to HIV-uninfected individuals. Here we assessed the ability of the Johnson and Johnson Ad26.CoV2.S vaccine to elicit neutralizing antibodies to the Delta variant in PLWH relative to HIV-uninfected individuals. Methods We enrolled 26 PLWH and 73 HIV-uninfected participants from the SISONKE phase 3b open label South African clinical trial of the Ad26.CoV2.S vaccine in health care workers (HCW) in a prospective observational cohort study. Enrollment was a median 56 days (range 19-98 days) post-vaccination. HCW PLWH had well suppressed HIV viremia. As a comparison, we also enrolled unvaccinated participants previously infected with SARS-CoV-2. This group consisted of 34 PLWH and 28 HIV-uninfected individuals. We used the presence of SARS-CoV-2 nucleocapsid antibodies and any previous record of SARS-CoV-2 infection to differentiate the vaccinated participants into participants who were previously infected with SARS-CoV-2 and those not previously infected. Neutralization capacity was assessed using participant plasma in a live virus neutralization assay of the Delta SARS-CoV-2 variant currently dominating infections in South Africa. This study was approved by the Biomedical Research Ethics Committee at the University of KwaZulu-Natal (reference BREC/00001275/2020). Findings Unvaccinated PLWH showed 6-fold reduced neutralization of the Delta variant relative to HIV-uninfected participants (GMT=105 for HIV-uninfected, 15 for PLWH, p=0.001). The majority (68%) of Ad26.CoV2.S vaccinated HCW were found to be previously infected with SARS-CoV-2. In this group, Delta variant neutralization was 9-fold higher compared to the infected only group (GMT of 306 versus 36) and 26-fold higher relative to the vaccinated only group (GMT=12). There was no significant difference in Delta variant neutralization in vaccinated and previously SARS-CoV-2 infected PLWH relative to vaccinated and previously SARS-CoV-2 infected, HIV-uninfected participants (GMT of 300 for PLWH versus 307 for HIV-uninfected). Vaccinated only participants showed a low neutralization of the Delta variant, with a stronger response in PLWH (GMT=73, for PLWH, 6 for HIV-uninfected, p=0.02). Interpretation While PLWH showed reduced neutralization of the Delta variant following SARS-CoV-2 infection, the neutralization response following Ad26.CoV2.S vaccination was not inferior to HIV-uninfected study participants. Funding South African Medical Research Council, The Bill & Melinda Gates Foundation.

scholarly journals Subclinical Atherosclerosis Imaging in People Living with HIV

2019 ◽  
Vol 8 (8) ◽  
pp. 1125 ◽  
Author(s):  
Isabella C. Schoepf ◽  
Ronny R. Buechel ◽  
Helen Kovari ◽  
Dima A. Hammoud ◽  
Philip E. Tarr
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Imaging Modality ◽  
Imaging Techniques ◽  
Subclinical Atherosclerosis ◽  
People Living With Hiv ◽  
Black Blood ◽  
Increased Risk ◽  
Calcified Plaque ◽  
Living With Hiv

In many, but not all studies, people living with HIV (PLWH) have an increased risk of coronary artery disease (CAD) events compared to the general population. This has generated considerable interest in the early, non-invasive detection of asymptomatic (subclinical) atherosclerosis in PLWH. Ultrasound studies assessing carotid artery intima-media thickness (CIMT) have tended to show a somewhat greater thickness in HIV+ compared to HIV−, likely due to an increased prevalence of cardiovascular (CV) risk factors in PLWH. Coronary artery calcification (CAC) determination by non-contrast computed tomography (CT) seems promising to predict CV events but is limited to the detection of calcified plaque. Coronary CT angiography (CCTA) detects calcified and non-calcified plaque and predicts CAD better than either CAC or CIMT. A normal CCTA predicts survival free of CV events over a very long time-span. Research imaging techniques, including black-blood magnetic resonance imaging of the vessel wall and 18F-fluorodeoxyglucose positron emission tomography for the assessment of arterial inflammation have provided insights into the prevalence of HIV-vasculopathy and associated risk factors, but their clinical applicability remains limited. Therefore, CCTA currently appears as the most promising cardiac imaging modality in PLWH for the evaluation of suspected CAD, particularly in patients <50 years, in whom most atherosclerotic coronary lesions are non-calcified.

scholarly journals Chronic Diseases Multimorbidity among Adult People Living with HIV at Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Endrias Markos Woldesemayat
Keyword(s):  
Chronic Diseases ◽  
Heart Diseases ◽  
The Body ◽  
Noncommunicable Disease ◽  
People Living With Hiv ◽  
Specialized Hospital ◽  
Increased Risk ◽  
Significant Difference ◽  
Living With Hiv ◽  
Hawassa University

Background. Due to the wide implementation of antiretroviral therapy (ART), people living with HIV (PLWHIV) are now living longer. This increased the risk of developing noncommunicable chronic diseases (NCCDs) among them. Objective. We aimed to describe prevalence of NCCDs multimorbidity among PLWHIV at Hawassa University Comprehensive Specialized Hospital (HUCSH). Method. In April 2016, institution-based cross-sectional study was conducted among PLWHIV, aged≥18 years at the ART unit of HUCSH. A nurse working in the ART unit interviewed patients and reviewed medical records. Data on the NCCDs and its risk factors were obtained. List of diseases considered in this study were arthritis, diabetes mellitus, hypertension, congestive heart failure (CHF), rheumatic heart diseases (RHD), chronic bronchitis, asthma, and cancer. Results. More than half of the respondents (196) had at least one of the NCCDs and 34 (8.9%) had multimorbidity. The main system of the body affected were the musculoskeletal system, 146 (38.2%) and respiratory system, 46 (12.0%). There was no significant difference in the prevalence of individual NCCDs by gender. Patients aged above 44 years, patients with ART duration of at least 6 years, and patients with higher CD4 counts had increased odds of having any one of the NCCDs. Multimorbidity patients with a longer ART duration had an increased risk. Conclusion. The prevalence of NCCD multimorbidity among PLWHIV was high. Monitoring the occurrence of NCCDs among PLWHIV and noncommunicable disease care is recommended.

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