1
|
Batta Y, King C, Cooper F, Johnson J, Haddad N, Boueri MG, DeBerry E, Haddad GE. Direct and indirect cardiovascular and cardiometabolic sequelae of the combined anti-retroviral therapy on people living with HIV. Front Physiol 2023; 14:1118653. [PMID: 37078025 PMCID: PMC10107050 DOI: 10.3389/fphys.2023.1118653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/17/2023] [Indexed: 03/29/2023] Open
Abstract
With reports of its emergence as far back as the early 1900s, human immunodeficiency virus (HIV) has become one of the deadliest and most difficult viruses to treat in the era of modern medicine. Although not always effective, HIV treatment has evolved and improved substantially over the past few decades. Despite the major advancements in the efficacy of HIV therapy, there are mounting concerns about the physiological, cardiovascular, and neurological sequelae of current treatments. The objective of this review is to (Blattner et al., Cancer Res., 1985, 45(9 Suppl), 4598s-601s) highlight the different forms of antiretroviral therapy, how they work, and any effects that they may have on the cardiovascular health of patients living with HIV, and to (Mann et al., J Infect Dis, 1992, 165(2), 245-50) explore the new, more common therapeutic combinations currently available and their effects on cardiovascular and neurological health. We executed a computer-based literature search using databases such as PubMed to look for relevant, original articles that were published after 1998 to current year. Articles that had relevance, in any capacity, to the field of HIV therapy and its intersection with cardiovascular and neurological health were included. Amongst currently used classes of HIV therapies, protease inhibitors (PIs) and combined anti-retroviral therapy (cART) were found to have an overall negative effect on the cardiovascular system related to increased cardiac apoptosis, reduced repair mechanisms, block hyperplasia/hypertrophy, decreased ATP production in the heart tissue, increased total cholesterol, low-density lipoproteins, triglycerides, and gross endothelial dysfunction. The review of Integrase Strand Transfer Inhibitors (INSTI), Nucleoside Reverse Transcriptase Inhibitors (NRTI), and Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI) revealed mixed results, in which both positive and negative effects on cardiovascular health were observed. In parallel, studies suggest that autonomic dysfunction caused by these drugs is a frequent and significant occurrence that needs to be closely monitored in all HIV + patients. While still a relatively nascent field, more research on the cardiovascular and neurological implications of HIV therapy is crucial to accurately evaluate patient risk.
Collapse
Affiliation(s)
- Yashvardhan Batta
- Department of Physiology and Biophysics, College of Medicine, Howard University, Washington, DC, United States
| | - Cody King
- Department of Physiology and Biophysics, College of Medicine, Howard University, Washington, DC, United States
| | - Farion Cooper
- Department of Physiology and Biophysics, College of Medicine, Howard University, Washington, DC, United States
| | - John Johnson
- Delaware Psychiatric Center, New Castle, DE, United States
| | - Natasha Haddad
- Department of Physiology and Biophysics, College of Medicine, Howard University, Washington, DC, United States
| | | | - Ella DeBerry
- Department of Physiology and Biophysics, College of Medicine, Howard University, Washington, DC, United States
| | - Georges E. Haddad
- Department of Physiology and Biophysics, College of Medicine, Howard University, Washington, DC, United States
| |
Collapse
|
2
|
High Concordance between D:A:Dr and the Framingham Risk Score in Brazilians Living with HIV. Viruses 2023; 15:v15020348. [PMID: 36851562 PMCID: PMC9960260 DOI: 10.3390/v15020348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/27/2023] Open
Abstract
People living with HIV (PLHIV) have twice the risk of developing cardiovascular diseases, making it essential to identify high cardiovascular risk (CVR). However, there is no validated CVR calculator for PLHIV in Brazil. We performed a cross-sectional study with 265 individuals living with HIV, aged 40 to 74 years, to assess the agreement between three CVR scores: Framingham Risk Score (FRS), Atherosclerotic Cardiovascular Disease (ASCVD) Risk Score, and a specific for PLHIV, Reduced Data Collection on Adverse Effects of Anti-HIV Drugs (D:A:Dr). We assessed agreement using the weighted Kappa coefficient and the Bland-Altman plot. The median age was 52 years (47-58), 58.9% were men, 34% were hypertensive and 8.3% had a detectable viral load. There was an almost perfect agreement between D:A:Dr x FRS (k = 0.82; 95% CI 0.77-0.87; p < 0.001), and substantial agreement between FRS vs. ASCVD (k = 0.74; 95% CI 0.69-0.79; p < 0.001) and between D:A:Dr vs. ASCVD (k = 0.70; 95% CI 0.64-0.76; p < 0.001). The Bland-Altman plot revealed greater discordance between scores as the CVR increased. Our results suggest that the FRS and the D:A:Dr are adequate to classify the CVR in this population, and the D:A:Dr score can be used as an alternative to the FRS in Brazil, as other international guidelines have already advocated.
Collapse
|
3
|
Antony I, Kannichamy V, Banerjee A, Gandhi AB, Valaiyaduppu Subas S, Hamid P. An Outlook on the Impact of HIV Infection and Highly Active Antiretroviral Therapy on the Cardiovascular System - A Review. Cureus 2020; 12:e11539. [PMID: 33354483 PMCID: PMC7746328 DOI: 10.7759/cureus.11539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 11/18/2020] [Indexed: 12/22/2022] Open
Abstract
HIV has been related to various cardiovascular pathologies in both adults and children. Highly active antiretroviral therapy (HAART) has been effective in subduing viral replication and improving immunity thereby reducing the effects of HIV both in AIDS and other chronic diseases related to the virus. Complications related to HAART have been reported with metabolic disorders and cardiac effects seen based on the therapy. HIV and HAART have shown to have direct effects on the cardiovascular system, and more public awareness and medical knowledge are required on this subject. This literature review tries to shed some light on the role of HIV and HAART in the cardiovascular manifestations seen in HIV-infected individuals.
Collapse
Affiliation(s)
- Ishan Antony
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Vishmita Kannichamy
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Amit Banerjee
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Arohi B Gandhi
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | | | - Pousette Hamid
- Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| |
Collapse
|
4
|
Gordon HP, Katz MG, Fargnoli AS, Gillespie VL, Hajjar RJ, Bridges CR. Scar Size and Other Parameters for Tracking Left Ventricular Dysfunction after Induction of Myocardial Infarcts in Sheep ( Ovisaries). Comp Med 2018; 68:215-220. [PMID: 29747722 DOI: 10.30802/aalas-cm-17-000040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In humans, cardiovascular disease (CVD) is the most frequent cause of death worldwide. Myocardial infarction (MI) is a leading cause of heart failure due to myocardial impairment, yet the progression of the resultant dysfunction is often undetected after incidental or induced myocardial infarction. In this study we tracked the progression of left-sided heart failure in 6-mo-old male castrated sheep in which we created 2 models of myocardial infarction, small and large. Myocardial infarction was induced through ligation of a single branch (obtuse marginal [OM] 1) of the left circumflex coronary artery to create small (mild) infarcts and of 2 branches (OM1 and OM2) for large (severe) infarcts. Progression of heart failure was evaluated by assessing scar size, the left ventricular ejection fraction, hematology, cardiac serum biochemical biomarkers, ST elevation, and clinical observation. All parameters were assessed at baseline and at 3 wk and 3 mo after infarction, except that clinical observation of the animals was conducted daily. The different parameters differed in their usefulness: some verified appropriate creation of the model, whereas others enabled assessment of the progression of heart disease. We hypothesize that myocardial scar size, as a function of induced ischemia, coupled with left ventricular ejection fraction are predictive indicators of postinfarction cardiac dysfunction.
Collapse
Affiliation(s)
- Hylton P Gordon
- Center for Comparative Medicine and Surgery, Icahn School of Medicine, Mt Sinai, New York, New York, USA.
| | - Michael G Katz
- Cardiovascular Research Center, Icahn School of Medicine, Mt Sinai, New York, New York, USA
| | - Anthony S Fargnoli
- Cardiovascular Research Center, Icahn School of Medicine, Mt Sinai, New York, New York, USA
| | - Virginia L Gillespie
- Center for Comparative Medicine and Surgery, Icahn School of Medicine, Mt Sinai, New York, New York, USA
| | - Roger J Hajjar
- Cardiovascular Research Center, Icahn School of Medicine, Mt Sinai, New York, New York, USA
| | - Charles R Bridges
- Cardiovascular Research Center, Icahn School of Medicine, Mt Sinai, New York, New York, USA
| |
Collapse
|
5
|
Cardiovascular markers of inflammation and serum lipid levels in HIV-infected patients with undetectable viremia. Sci Rep 2018; 8:6113. [PMID: 29666424 PMCID: PMC5904142 DOI: 10.1038/s41598-018-24446-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 04/03/2018] [Indexed: 01/08/2023] Open
Abstract
Patients successfully treated for HIV infection still have an increased risk for cardiovascular morbidity and mortality, which might be related not only to traditional risks, but also to inflammation and dyslipidemia. We examined the relationship of serum lipid levels with plasma biomarkers of inflammation using a composite inflammatory burden score (IBS) based on individual (>75th percentile) measurements from the following seven markers: CD40L, tPA, MCP-1, IL-8, IL-6, hCRP and P-selectin. IBS was categorized as 0 (none of the biomarkers >75th percentile), 1, 2 and 3 or more scores. Correlations between the IBS and lipid parameters were examined by ordered logistic regression proportional odds models to estimate the odds of more elevated biomarkers. 181 male patients with undetectable HIV-viremia were included into the study. In the multivariate model, a one-unit increase (mmol/L) of total cholesterol and triglycerides was associated with a 1.41-fold (95% CI, 1.13–1.76) and 1.37-fold (95% CI, 1.18–1.60) increased odds of having a greater IBS, respectively. Those with an IBS score ≥1 compared to none had 2.14 (95% CI, 1.43–3.20) higher odds of having a one-unit increased total cholesterol/HDL-cholesterol ratio. In successfully treated HIV-infected persons dyslipidemia was associated with inflammation.
Collapse
|
6
|
Mataró D, García D, Coll O, Vassena R, Rodríguez A. Lower endometrial receptivity in HIV-infected women receiving oocyte donation: a comorbidity of HIV infection? Hum Reprod Open 2017; 2017:hox019. [PMID: 30895233 PMCID: PMC6276669 DOI: 10.1093/hropen/hox019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 08/22/2017] [Accepted: 10/07/2017] [Indexed: 01/13/2023] Open
Abstract
STUDY QUESTION Are the reproductive outcomes of HIV-infected donor oocyte recipient women comparable to those of non-infected women? SUMMARY ANSWER HIV-infected women have lower clinical pregnancy and live birth rates than non-infected women. WHAT IS ALREADY KNOWN The literature on the effect of HIV infection on reproductive outcome is scarce at best; the only report to date comparing oocyte donation cycles in HIV-infected women versus non-infected controls found no differences in pregnancy rates between the two groups. However, this study was performed nearly a decade ago and did not evaluate the effect of immuno-virological characteristics of oocyte recipients or the HIV antiretroviral therapy effect. STUDY DESIGN SIZE, AND DURATION This is a matched-cohort study including 514 oocyte donation cycles, 257 from HIV-infected women and 257 non-infected controls, performed between April 2004 and November 2014. PARTICIPANTS/MATERIALS, SETTING, AND METHOD Each cycle of an HIV-infected woman (n = 257) was matched with a cycle of a non-infected woman (1:1). Biochemical pregnancy, clinical pregnancy, ongoing pregnancy and live birth in the two groups were compared using a multivariate logistic regression analysis. The effect of antiretroviral treatment options on pregnancy outcomes of HIV-infected women was analyzed using a logistic regression model adjusted for time elapsed from diagnosis, and CD4 levels and viral load prior to embryo transfer. MAIN RESULTS AND THE ROLE OF CHANCE Cycles of HIV-infected patients receiving oocyte donation presented lower pregnancy and live birth rates than matched non-infected controls. Treatment options and infection parameters analyzed do not seem to affect the reproductive results in HIV-infected women. The variable most influencing pregnancy outcomes was the number of transferred embryos; lower pregnancy rates were obtained after single embryo transfer. LIMITATIONS REASONS FOR CAUTION Patients with HIV infection have specific health issues, such as infection/treatment side effects, which makes it impossible to find a matching control group of non-infected patients for these variables. WIDER IMPLICATIONS OF THE FINDINGS HIV-infected women receiving donated oocytes present lower pregnancy rates when compared to non-infected controls, regardless of the antiretroviral treatment followed. The complexity of the treatments (both in medication types and combinations) makes it difficult to define whether any one treatment option is better than the others in terms of pregnancy outcomes in oocyte recipients. STUDY FUNDING/COMPETING INTERESTS None. TRIAL REGISTRATION NUMBER Not applicable.
Collapse
Affiliation(s)
- Daniel Mataró
- Clínica EUGIN, Travessera de Les Corts 322, Barcelona 08029, Spain
| | - Désirée García
- Fundació Privada EUGIN, Travessera de Les Corts 314, Barcelona 08029, Spain
| | - Oriol Coll
- Clínica EUGIN, Travessera de Les Corts 322, Barcelona 08029, Spain
| | - Rita Vassena
- Clínica EUGIN, Travessera de Les Corts 322, Barcelona 08029, Spain
| | - Amelia Rodríguez
- Clínica EUGIN, Travessera de Les Corts 322, Barcelona 08029, Spain
| |
Collapse
|
7
|
Carvalho AS, Osório Valente R, Almeida Morais L, Modas Daniel P, Sá Carvalho R, Ferreira L, Cruz Ferreira R. HIV and coronary disease - When secondary prevention is insufficient. Rev Port Cardiol 2017; 36:569.e1-569.e8. [PMID: 28697899 DOI: 10.1016/j.repc.2016.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/15/2016] [Accepted: 10/03/2016] [Indexed: 10/19/2022] Open
Abstract
Highly active antiretroviral therapy (HAART) has created a new paradigm for human immunodeficiency virus (HIV)-infected patients, but their increased risk for coronary disease is well documented. We present the case of a 57-year-old man, co-infected with HIV-2 and hepatitis B virus, adequately controlled and with insulin-treated type 2 diabetes and dyslipidemia, who was admitted with non-ST elevation acute myocardial infarction. Coronary angiography performed on day four of hospital stay documented two-vessel disease (mid segment of the right coronary artery [RCA, 90% stenosis] and the first marginal). Two drug-eluting stents were successfully implanted. The patient was discharged under dual antiplatelet therapy (aspirin 100 mg/day and clopidogrel 75 mg/day) and standard coronary artery disease medication. He was admitted to the emergency room four hours after discharge with chest pain radiating to the left arm and inferior ST-segment elevation myocardial infarction was diagnosed. Coronary angiography was performed within one hour and documented thrombosis of both stents. Optical coherence tomography revealed good apposition of the stent in the RCA, with intrastent thrombus. Angioplasty was performed, with a good outcome. The acute stent thrombosis might be explained by the thrombotic potential of HIV infection and diabetes. There are no specific guidelines regarding HAART in secondary prevention of acute coronary syndromes. A multidisciplinary approach is essential for optimal management of these patients.
Collapse
Affiliation(s)
- Ana Sofia Carvalho
- Serviço de Medicina Interna, Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal.
| | | | - Luís Almeida Morais
- Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal
| | - Pedro Modas Daniel
- Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal
| | - Ramiro Sá Carvalho
- Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal
| | - Lurdes Ferreira
- Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal
| | - Rui Cruz Ferreira
- Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal
| |
Collapse
|
8
|
HIV and coronary disease – When secondary prevention is insufficient. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2017. [DOI: 10.1016/j.repce.2016.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
9
|
Prado FLSD, Prado R, Ladeia AMT. Cardiovascular risk profile in patients with myelopathy associated with HTLV-1. Braz J Infect Dis 2017; 21:226-233. [PMID: 28282508 PMCID: PMC9427981 DOI: 10.1016/j.bjid.2017.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 12/23/2016] [Accepted: 01/04/2017] [Indexed: 12/14/2022] Open
Abstract
HAM/TSP (HTLV-1-associated myelopathy/tropical spastic paraparesis) is a slowly progressive disease, characterized by a chronic spastic paraparesis. It is not known if the disease carries an independent risk for cardiovascular disease. The objective of this study was to evaluate the cardiovascular risk profile related to HAM/TSP and compare it with the general population. Methods This was a cross-sectional study, with a control group. HAM/TSP patients were evaluated using cardiovascular risk scores (ASCVD RISK, SCORE and Framingham) and inflammatory markers (ultrasensitive CRP and IL-6), and compared with a control group of healthy individuals. We also evaluated the correlation between cardiovascular risk and the functional status of patients with HAM/TSP evaluated by the FIM scale. Results Eighty percent of patients in this study were females, mean age of 51 years (11.3). The control group showed an increased cardiovascular event risk in 10 years when ASCVD was analyzed (cardiovascular risk ≥7.5% in 10 years seen in 43% of patients in the control group vs. 23% of patients with HAM/TSP; p = 0.037). There was no difference in ultrasensitive CRP or IL-6 values between the groups, even when groups were stratified into low and high risk. There was no correlation between the functional status of HAM/TSP patients and the cardiovascular risk. Conclusions In this study, the cardiovascular risk profile of patients with HAM/TSP was better than the risk of the control group.
Collapse
Affiliation(s)
- Fabio Luís Silva do Prado
- Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil; Rede Sarah de Hospitais de Reabilitação, Salvador, BA, Brazil.
| | - Renata Prado
- Vanguard Skin Specialists, Colorado Springs, CO, United States
| | | |
Collapse
|
10
|
Pillay B, Ramdial PK, Naidoo DP, Sartorius B, Singh D. Endovascular Therapy for Large Vessel Vasculopathy in HIV-infected Patients. Eur J Vasc Endovasc Surg 2016; 52:343-51. [PMID: 27436174 DOI: 10.1016/j.ejvs.2016.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 06/08/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To evaluate outcomes after endovascular treatment of patients with aneurysmal or occlusive vasculopathy in HIV-infected patients. METHODS Retrospective analysis of a prospective database of treatment outcomes in patients with HIV related vasculopathies between April 2005 and September 2015. RESULTS Sixty HIV patients presented with post-traumatic pseudoaneurysm formation (n = 7), aneurysmal disease (n = 24) or occlusive disease (n = 29 (48%)). The majority were male (42/60 (70%)), with a mean age of 43.9 years (SD ± 12.6). All seven patients with a post-traumatic pseudoaneurysm were treated by insertion of a covered stent (n = 6) or coiling (n = 1). All were successfully treated at 30 days, but only one patient returned for late surveillance. 23/24 patients who underwent insertion of a stent graft/covered stent for aneurysmal disease returned for 30 day review (one asymptomatic stent graft occlusion). Only 11 patients attended for late surveillance; 9/11 were asymptomatic with patent stent grafts. Late stent occlusion occurred in two (no further action (n = 1), major limb amputation (n = 1). In the 29 patients who underwent endovascular treatment for occlusive disease, 9 (31%) had immediate treatment failure (including 8 amputations (28%)). Of the sixteen who returned for serial review, 8 (50%) suffered further complications including 4 amputations. Overall, 12/29 treated patients (41%) ultimately underwent amputation. CONCLUSIONS In the immediate short term, an 'endovascular first' strategy was associated with good outcomes in HIV patients with aneurysmal disease. By contrast, outcomes were poor in HIV patients with occlusive disease. Whether this relates to the underlying natural history of HIV occlusive vasculopathies remains unclear. One major problem in trying to formulate meaningful management strategies is a generalised reluctance for HIV patients to return for surveillance.
Collapse
Affiliation(s)
- B Pillay
- Department of Vascular/Endovascular Surgery, Durban, KwaZulu-Natal, South Africa; Nelson R Mandela School of Medicine, Durban, KwaZulu-Natal, South Africa; University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
| | - P K Ramdial
- Department of Anatomical Pathology, Durban, KwaZulu-Natal, South Africa; School of Laboratory Medicine & Medical Sciences, Durban, KwaZulu-Natal, South Africa; University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa; National Health Laboratory Service, Durban, KwaZulu-Natal, South Africa
| | - D P Naidoo
- Department of Cardiology, Durban, KwaZulu-Natal, South Africa; Nelson R Mandela School of Medicine, Durban, KwaZulu-Natal, South Africa; University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - B Sartorius
- Department of Public Health, Durban, KwaZulu-Natal, South Africa; School of Nursing and Public Health, Durban, KwaZulu-Natal, South Africa; University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - D Singh
- Department of Physics, Durban University of Technology, Durban, KwaZulu-Natal, South Africa
| |
Collapse
|
11
|
Rehm KE, Konkle-Parker D. Physical activity levels and perceived benefits and barriers to physical activity in HIV-infected women living in the deep south of the United States. AIDS Care 2016; 28:1205-10. [PMID: 27023306 DOI: 10.1080/09540121.2016.1164802] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Engaging in regular physical activity (PA) is important in maintaining health and increasing the overall quality of life of people living with HIV (PLWH). The deep south of the USA is known for its high rate of sedentary behavior although data on the activity levels and perceptions of the benefits and barriers to exercise in women living with HIV in the deep south are lacking. Understanding the perceived benefits and barriers to exercise can guide the development of PA interventions. We conducted a cross-sectional study to determine the PA levels and perceived benefits and barriers to exercise associated with both age and depression level in a group of HIV+ women living in the deep south. We recruited a total of 50 participants from a cohort site for the Women's Interagency HIV Study. Depression was assessed using the Center for Epidemiological Studies Depression Scale (CES-D) and benefits/barriers to exercise were measured using the Exercise Benefits and Barriers Scale (EBBS). We measured PA both subjectively and objectively using the International Physical Activity Questionnaire (IPAQ) and a Fitbit PA monitor, respectively. Our sample was predominantly African-American (96%) and the mean ±SD age, body mass index, and CES-D score were 42 ± 8.8 years, 36.6 ± 11.5 kg/m(2), and 15.6 ± 11.4, respectively. Both subjective and objective measures of PA indicated that our participants were sedentary. The greatest perceived benefit to exercise was physical performance and the greatest barrier to exercise was physical exertion. Higher overall perceived benefits were reported by women ≥43 years and women reporting higher levels of depression. There was no difference in overall barriers associated with age and depression level, but women with depression felt more fatigued by exercise. The results of this study can be helpful when designing and implementing PA interventions in women living with HIV in the deep south.
Collapse
Affiliation(s)
- Kristina E Rehm
- a Laboratory of Behavioral Immunology, Division of Clinical Immunology and Allergy , University of Mississippi Medical Center , Jackson , MS , USA
| | - Deborah Konkle-Parker
- b Division of Infectious Diseases , University of Mississippi Medical Center , Jackson , MS , USA
| |
Collapse
|
12
|
Gomes Neto M, Conceição CS, Ogalha C, Brites C. Aerobic capacity and health-related quality of life in adults HIV-infected patients with and without lipodystrophy. Braz J Infect Dis 2015; 20:76-80. [PMID: 26707972 PMCID: PMC9425419 DOI: 10.1016/j.bjid.2015.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 10/09/2015] [Accepted: 11/02/2015] [Indexed: 10/28/2022] Open
Abstract
INTRODUCTION HIV infection and its therapy which can affect their aerobic capacity and health-related quality of life of patients. OBJECTIVE We conducted a cross-sectional study to determine if aerobic capacity and health related quality of life was decreased in HIV-infected patients receiving highly active antiretroviral therapy and comparing patients with and without lipodystrophy. RESEARCH DESIGN AND METHODS HIV-infected patients older than 18 years, and in current use of highly active antiretroviral therapy drugs, were evaluated for blood count, fasting total cholesterol, high density lipoprotein, triglycerides, glucose, HIV viral load and CD4/CD8 counts, body composition, peak oxygen consumption (peak VO2) and metabolic equivalent. Health related quality of life was assessed by using Short Form-36 (SF-36). Statistical analysis was carried out using SPSS version 20.0. RESULTS A total of 63 patients with mean age of 43.1±6.4 years were evaluated, of these 34 (54%) had lipodystrophy. The average peak VO2 (31.4±7.6mLkg(-1)min(-1)) was significantly lower (p<0.01) than expected values (37.9±5.6mLkg(-1)min(-1)) according to the characteristics of the patients. The lipodystrophy group presented with a significant difference in muscle mass, body fat, peak VO2 and metabolic equivalent and in functional capacity domains of SF-36. CONCLUSION Aerobic capacity values were reduced in HIV-infected patients under highly active antiretroviral therapy when compared to predicted values. Lipodystrophy was associated with reduced aerobic capacity and higher frequency of metabolic syndrome. Lifestyle modification should be a priority in the management of chronic HIV disease.
Collapse
Affiliation(s)
- Mansueto Gomes Neto
- Departamento de Biofunção, Curso de Fisioterapia, Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil; Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil.
| | - Cristiano Sena Conceição
- Departamento de Biofunção, Curso de Fisioterapia, Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
| | - Cecília Ogalha
- Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
| | - Carlos Brites
- Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
| |
Collapse
|
13
|
Grace JM, Semple SJ, Combrink S. Exercise therapy for human immunodeficiency virus/AIDS patients: Guidelines for clinical exercise therapists. J Exerc Sci Fit 2015; 13:49-56. [PMID: 29541099 PMCID: PMC5812861 DOI: 10.1016/j.jesf.2014.10.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 10/15/2014] [Accepted: 10/27/2014] [Indexed: 02/04/2023] Open
Abstract
Human immunodeficiency virus (HIV) has infected > 60 million people since its discovery and 30 million people have died since the pandemic began. Antiretroviral therapy has transformed HIV infection from an acute to a chronic disease, increasing life expectancy but also adding to the potential side effects associated with drug therapy and the comorbidity accompanying longevity. Exercise can play a valuable role in the management of HIV/AIDS patients by addressing various symptoms and improving their quality of life, but the optimum mode, intensity, frequency, and duration of exercise that take the different clinical stages of the disease into consideration are inadequately known. Searches of Medline, Embase, Science Citation Index, CINAHL database, HealthSTAR, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, Physiotherapy Evidence Database (PEDro), and SPORTDiscus were conducted between 2000 and January 2014. Searches of published and unpublished abstracts were conducted, as well as a hand search of reference lists and tables of contents of relevant journals and books. Identified studies were reviewed for methodological quality. A total of 33 studies met the inclusion criteria. Most studies failed to indicate the optimum type (mode), intensity, frequency, and duration of aerobic and progressive resistive exercise prescribed to HIV-infected individuals in relation to the different clinical stages of the disease. The purpose of this review is to provide evidence-based recommendations after revision of exercise guidelines for HIV patients, by highlighting practical guidelines that clinical exercise therapists should consider when prescribing exercise for patients in different stages of the disease.
Collapse
Affiliation(s)
- Jeanne M. Grace
- Faculty of Science and Agriculture, Department of Biokinetics and Sport Science, University of Zululand, Kwadlangezwa, South Africa
| | | | | |
Collapse
|
14
|
Cardiovascular disease in human immunodeficiency virus-infection as a cause of hospitalization: a case-series in a General Hospital in Peru. Braz J Infect Dis 2015; 19:431-5. [PMID: 25892316 PMCID: PMC9427453 DOI: 10.1016/j.bjid.2015.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 03/03/2015] [Accepted: 03/05/2015] [Indexed: 12/16/2022] Open
Abstract
Background Cardiovascular disease in the context of human immunodeficiency virus infection has become a major clinical concern in recent years. In the current report we assess hospitalizations due to cardiovascular disease in human immunodeficiency virus patients in a Social Security reference hospital in Peru. Methods A retrospective study was carried out between January 1996 and December 2012 in a General Hospital in Lima, Peru. Results We included 26 patients hospitalized due to cardiovascular disease. Mean age was 46.3 years (SD 12.5), predominantly male (57.7%). Ten patients (38.4%) were in Acquired Immunodeficiency Syndrome stages. Seventeen (65.4%) received high-active-antiretroviral therapy. Eleven (42.3%) had cardiac involvement and 15 (57.7%) had non-cardiac vascular involvement. The most frequent causes of cardiac involvement were pericardial effusion and myocardial infarction. On the other hand, deep vein thrombosis and stroke were the most frequent for non-cardiac vascular involvement. Conclusions Cardiovascular disease is an important cause of hospitalization in Peruvian human immunodeficiency virus patients, with differences between immunosuppression stages. Further studies analyzing associated factors are warranted.
Collapse
|