scholarly journals Human Immunodeficiency Virus Associated Large Artery Disease

2020 ◽  
Author(s):  
Ruchika Meel ◽  
Ricardo Gonçalves
Keyword(s):  
Human Immunodeficiency Virus ◽  
Large Artery ◽  
Immunodeficiency Virus ◽  
Artery Disease

scholarly journals Risk of coronary artery disease in individuals infected with human immunodeficiency virus

2011 ◽  
Vol 15 (6) ◽  
pp. 521-527 ◽  
Author(s):  
Felippe Dantas Vilela ◽  
Andrea Rocha de Lorenzo ◽  
Bernardo Rangel Tura ◽  
Giovanna Ianini Ferraiuoli ◽  
Marcelo Hadlich ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Human Immunodeficiency Virus ◽  
Coronary Artery ◽  
Immunodeficiency Virus ◽  
Artery Disease

Trends and perioperative outcomes of patients with human immunodeficiency virus (HIV) undergoing lower extremity revascularization

2020 ◽  
Vol 25 (6) ◽  
pp. 527-533
Author(s):  
Tanner I Kim ◽  
Anand Brahmandam ◽  
Timur P Sarac ◽  
Kristine C Orion
Keyword(s):  
Human Immunodeficiency Virus ◽  
Lower Extremity ◽  
Hospital Costs ◽  
Major Amputation ◽  
Perioperative Outcomes ◽  
Hiv Status ◽  
Immunodeficiency Virus ◽  
Multivariable Regression ◽  
Artery Disease ◽  
Lower Extremity Revascularization

The development of highly active antiretroviral therapy (HAART) has significantly improved the life expectancy of patients with human immunodeficiency virus (HIV), but has led to the rise of chronic conditions including peripheral artery disease (PAD). However, trends and outcomes among patients with HIV undergoing lower extremity revascularization are poorly characterized. The aim of this study was to investigate the trends and perioperative outcomes of lower extremity revascularization among patients with HIV and PAD in a national database. The National Inpatient Sample (NIS) was reviewed between 2003 and 2014. All hospital admissions with a diagnosis of PAD undergoing lower extremity revascularization were stratified based on HIV status. Outcomes were assessed using propensity score matching and multivariable regression. Among all patients undergoing lower extremity revascularization for PAD, there was a significant increase in the proportion of patients with HIV from 0.21% in 2003 to 0.52% in 2014 ( p < 0.01). Patients with HIV were more likely to be younger, male, and have fewer comorbidities, including coronary artery disease and diabetes, at the time of intervention compared to patients without HIV. With propensity score matching and multivariable regression, HIV status was associated with increased total hospital costs, but not length of stay, major amputation, or mortality. Patients with HIV with PAD who undergo revascularization are younger with fewer comorbidities, but have increased hospital costs compared to those without HIV. Lower extremity revascularization for PAD is safe for patients with HIV without increased risk of in-hospital major amputation or mortality, and continues to increase each year.

scholarly journals Brain Large Artery Lymphocytic Inflammation and Human Immunodeficiency Virus-Related Brain Arterial Remodeling

2018 ◽  
Vol 92 (12) ◽  
Author(s):  
Adele Shenoy ◽  
Andrew Dwork ◽  
Mitchell S. V. Elkind ◽  
Randolph Marshall ◽  
Susan Morgello ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
T Cells ◽  
T Cell ◽  
Immunohistochemical Analysis ◽  
Large Artery ◽  
Arterial Remodeling ◽  
Cd4 Counts ◽  
Brain Arteries ◽  
Increased Risk ◽  
Immunodeficiency Virus

ABSTRACTThe pathogenesis of increased stroke risk in human immunodeficiency virus (HIV) remains unclear. Our study investigated the relationship between adventitial and intimal CD3+T cells and brain arterial remodeling that potentially contributes to HIV-related vasculopathy and stroke. Large brain arteries from 84 HIV+cases and 78 HIV−cases were analyzed to determine interadventitial and luminal diameters, intimal and wall thickness, percent stenosis, and the presence of atherosclerosis. Immunohistochemical analysis was performed to detect and visually score CD3, a pan-T-cell marker, in the intima and adventitia. Our study showed that numbers of adventitial CD3+T cells are lower among persons with HIV than among those without HIV, especially if CD4 counts are <200, though intimal CD3+T cell numbers did not differ by HIV status. Among those with HIV but CD4 counts of <200 at the time of death, intimal CD3+T cells were associated with hypertrophic outward remodeling, while among those with HIV and CD4 of >200 or HIV−controls, intimal CD3+T cells were associated with hypertrophic inward remodeling. We conclude that intimal lymphocytic inflammation is involved in brain arterial remodeling that may contribute to HIV-related cerebrovascular pathology.IMPORTANCEAlthough mortality from human immunodeficiency virus (HIV) has decreased with the use of combination antiretroviral therapies, there is now an increased risk of cardiovascular and cerebrovascular disease associated with HIV. Thus, there is a need to understand the pathogenesis of stroke in HIV infection. Our study examines how lymphocytic inflammation in brain arteries may contribute to increased cerebral vasculopathy. With this understanding, our study can potentially help direct future therapies to target and prevent brain arterial remodeling processes associated with HIV.

scholarly journals Association of Human Immunodeficiency Virus Infection and Risk of Peripheral Artery Disease

Circulation ◽  
2018 ◽  
Vol 138 (3) ◽  
pp. 255-265 ◽  
Author(s):  
Joshua A. Beckman ◽  
Meredith S. Duncan ◽  
Charles W. Alcorn ◽  
Kaku So-Armah ◽  
Adeel A. Butt ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Virus Infection ◽  
Human Immunodeficiency Virus Infection ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Immunodeficiency Virus ◽  
Artery Disease

P5338Atherosclerotic cardiovascular events in people living with Human Immunodeficiency Virus

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
F Boccara ◽  
S Lang ◽  
S Ederhy ◽  
L Soulat-Dufour ◽  
S Adavane-Scheuble ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Human Immunodeficiency Virus ◽  
Coronary Artery ◽  
High Risk ◽  
Vascular Risk ◽  
Factors Associated ◽  
Immunodeficiency Virus ◽  
Observational Cohort ◽  
Artery Disease

Abstract Background People living with Human Immunodeficiency Virus (PLWHIV) under antiretrovirals have an increased risk of atherosclerotic cardiovascular disease (ASCVD) events. The risk factors associated with ASCVD events in this high risk population are various including traditional vascular risk factors and specific HIV-related factors. However their respective influence is questionable. Purpose Our aim was to determine the incidence of ASCVD events in a large cohort of PLWHIV and to identify the risk factors associated. Methods We conducted a longitudinal observational cohort study of asymptomatic PLWHIV at high risk of ASCVD addressed to our preventive cardiovascular unit for non-invasive cardiovascular evaluation. The first ASCVD event was censored and included CV death, acute coronary syndromes, coronary and peripheral revascularizations (PCI or CABG or endarterectomy or limb procedures) and ischemic strokes. Results From January 2003 to December 2014, 763 consecutive asymptomatic PLWHIV were enrolled (mean age of 51.3±8.3 years, 87% men, 90% were free of known coronary artery disease, mean Left ventricular ejection fraction 60%). At baseline, traditional CV risk factors were as follow: 54% had dyslipidemia, 43% hypertension, 35% were active smokers, 22% had family history of CAD and 11% were diabetics. Statins were prescribed in 38% of the cohort, aspirin in 14%, clopidogrel in 14% betablockers in 14%, RAS blockers in 32%, Calcium channel blockers in 8%. At baseline, median duration of HIV seropositivity was 19.8 years (14.0–23.6), 94% were under ARV predominantly protease inhibitors (68%). Median CD4 cell count was 545/mm3 (404–745) and 92% had undetectable HIV viral load. During a median follow up of 5.8 years (3.7–8.7), 58 (7.3%) subjects had a first ASCVD event (incidence of 12.70 [9.78–16.51] per 1000 persons-years) including 5 cardiovascular deaths, 14 ACS, 20 coronary revascularizations, 13 peripheral vascular procedures and 6 strokes) with a median time of occurrence of 3.1 years (1.5–5.1). CV death (first and second ASCVD events) occurred in 8 patients (22%) after CV death related to malignancies (33%) but before deaths related to unexplained causes (21%), infectious disease (13%), liver disease (8%) and suicides (3%). Coronary events including coronary death, MI, and coronary revascularization occurred in 39 patients (5.2%); Incidence of 8.28 [6.00–11.43] per 1000 persons-years. Conventional multivariate Cox model shows that age and tobacco were the independent risk factors associated with ACSVD events [Hazard ratio (HR) 1.04, 95% CI 0.99–1.09, p=0.05 and HR 2.17, 95% CI 1.07–4.38, p=0.03]. Conclusion Traditional vascular risk factors (age and active smoking) are associated with the occurrence of ASCVD events predominantly coronary artery disease in our observational cohort of asymptomatic PLWIHV at high risk for ASCVD. Cardiovascular prevention including tobacco cease action is mandatory in the aging HIV population.

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