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Oliva-Sánchez PF, Landeros-López S, Rosas-Dossetti MM, Grobeisen-Levin S, Islas-Martínez JA, Aznar-Guerra D, Valdez-Celiz AP, Soto-Ramírez L. Comparison of Four Predictive Scores for Cardiovascular Risk in Mexican People with HIV. AIDS Res Hum Retroviruses 2024; 40:439-448. [PMID: 38666685 DOI: 10.1089/aid.2023.0085] [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] [Indexed: 05/16/2024] Open
Abstract
Persons with HIV (PWH) face an increased risk of cardiovascular events due to immune activation, comorbidities, and certain antiretrovirals (ARVs). However, the current cardiovascular risk (CVR) scores are not specifically directed toward PWH. This study aimed to assess the agreement between different predictive CVR scores and explore their relationship with clinical and demographic data in Mexican PWH. A descriptive cross-sectional analysis was conducted in 200 PWH with a mean age of 42 years who were treated at a Mexican urban center from 2017 to 2018. The majority (83%) was on ARV treatment and 79.5% had undetectable viral loads (VLs). Moderate- to high-risk scores were infrequent, with Framingham Risk Score for Hard Coronary Heart Disease scores showing higher values, with very low concordance among all scores. Logistic regression analysis revealed significant associations between the CVR scores and the initial recorded VL, CD4 cell count, and elevated triglyceride levels. However, no associations were found with measures such as body mass index or abdominal circumference. Treatment with integrase strand transfer inhibitors (INSTIs), particularly first-generation inhibitors, showed strong associations with all predictive scores, notably ASCVD (odds ratio = 7.03, 95% confidence interval 1.67-29.64). The poor concordance among the CVR scores in PWH highlights the need for a specific score that considers comorbidities and ARV drugs. Despite the relatively young age of the participants, significant correlations were observed between INSTI use, initial VL, CD4 cell count, and triglyceride levels, which are factors not considered in the existing risk scores. Regardless of the actual value of the scores, screening for CVR in PWH is recommended.
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Affiliation(s)
- P F Oliva-Sánchez
- El Instituto Nacional de Medicina Genomica, Mexico City, Mexico
- Departamento de Atención a la Salud, Universidad Autónoma Metropolitana - Xochimilco, Mexico City, Mexico
| | | | - M M Rosas-Dossetti
- Hospital General "Vicente Villada", Instituto de Salud del Estado de México, Toluca, Mexico
| | - S Grobeisen-Levin
- Departamento de Atención a la Salud, Universidad Autónoma Metropolitana - Xochimilco, Mexico City, Mexico
| | - J A Islas-Martínez
- Facultad Mexicana de Medicina, Universidad La Salle, Ciudad de México, Mexico
| | - D Aznar-Guerra
- Facultad Mexicana de Medicina, Universidad La Salle, Ciudad de México, Mexico
| | - A P Valdez-Celiz
- Facultad de Medicina, Universidad Autónoma de Baja California, Mexicali, Mexico
| | - L Soto-Ramírez
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Ciudad de Mexico, Mexico
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2
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Aomori M, Matsumoto C, Takebayashi S, Matsuyama N, Uto Y, Tanaka M, Samukawa S, Kato H, Nakajima H, Maeda H. Effects of a smartphone app-based diet and physical activity program for men living with HIV who have dyslipidemia: A pilot randomized controlled trial. Jpn J Nurs Sci 2023:e12535. [PMID: 37060244 DOI: 10.1111/jjns.12535] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/24/2023] [Accepted: 03/06/2023] [Indexed: 04/16/2023]
Abstract
AIMS People living with HIV are at a high risk for cardiovascular disease owing to antiretroviral therapy use and chronic inflammation. There is limited evidence on the evaluation of serum lipid levels through lifestyle modification. This study aims to evaluate the effect of a smartphone application-based diet and exercise improvement program on men living with HIV and dyslipidemia. METHODS This was a randomized controlled trial recruiting Japanese men living with HIV who have dyslipidemia: intervention group (n = 19) and control group (n = 19). The intervention group received a third individual guidance session during the 6-month intervention and was encouraged to record their diet on a smartphone application. An intention-to-treat analysis of the results was conducted. RESULTS The intervention group showed significantly reduced change in low-density lipoprotein levels compared to the control group (-4.00 ± 20.2 mg/dL vs. 10.11 ± 21.1 mg/dL) (p = .042) from baseline to 6 months post-intervention. No significant differences were found in other serum lipid levels. Abdominal circumference decreased significantly in the intervention group (p = .048) from baseline to 6 months post-intervention. Total energy, protein, carbohydrate, fat, and salt intake, dietary and physical activity behavior change stages and social support, dietary self-efficacy, and loneliness significantly improved in the intervention group (p < .05) from baseline to 6 months post-intervention. CONCLUSIONS A diet and physical activity improvement program using a smartphone application based on Japanese-specific health guidance may reduce low-density lipoprotein cholesterol levels in this population. Further sample expansion and examination of long-term effects are needed.
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Affiliation(s)
- Maki Aomori
- Doctoral Program of Nursing, Graduate School of Health Sciences, Kumamoto University, Kumamoto, Japan
- Department of Nursing, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Chiharu Matsumoto
- Department of Nursing, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Sanae Takebayashi
- Nursing Department, Yokohama City University Hospital, Yokohama, Japan
| | - Nao Matsuyama
- Nursing Department, Yokohama City University Hospital, Yokohama, Japan
| | - Yukiko Uto
- Nursing Department, Yokohama City University Hospital, Yokohama, Japan
| | - Miho Tanaka
- Nursing Department, Yokohama City University Hospital, Yokohama, Japan
| | - Sei Samukawa
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hideaki Kato
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
- Infection Prevention and Control Department, Yokohama City University Hospital, Yokohama, Japan
| | - Hideaki Nakajima
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hitomi Maeda
- Department of Nursing, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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Taiwo BO, Romdhani H, Lafeuille MH, Bhojwani R, Milbers K, Donga P. Treatment and comorbidity burden among people living with HIV: a review of systematic literature reviews. J Drug Assess 2022; 12:1-11. [PMID: 36582675 PMCID: PMC9793945 DOI: 10.1080/21556660.2022.2149963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background As the human immunodeficiency virus (HIV) treatment landscape continues to evolve, the prolonged life expectancy and long-term exposure to antiretroviral drugs have modified the burden associated with living with HIV. Objective To better understand the current treatment and comorbidity burden in people living with HIV (PLWH). Methods Peer-reviewed systematic literature reviews (SLRs) between 2017 and 2020 that included US studies and examined drug adherence/pill burden, resistance burden, or comorbidities in PLWH were identified. Methods and findings were extracted for the overall studies and examined in the subset of US studies. Results Among 665 publications identified, 47 met the inclusion criteria (drug adherence/pill burden: 5; resistance: 3; comorbidities: 40). While antiretroviral drug adherence levels varied across SLRs, single-tablet regimens (STR) were associated with higher adherence versus multiple-tablet regimens. STRs were also associated with lower risk of treatment discontinuation, higher cost-effectiveness, and lower risk of hospitalization. Longer survival resulted in a high comorbidity burden, with non-AIDS causes accounting for 47% of deaths among PLWH in the US. HIV doubled the risk of cardiovascular disease and was associated with other health problems, including bone and muscle diseases, depression, and cancers. Several antiretroviral regimens were associated with chronic diseases, including cardiometabolic conditions. Lifetime HIV costs are substantially increasing, driven by antiretroviral, adverse event, and comorbidity treatment costs cumulated due to longer survival times. Conclusions There is a considerable burden associated with HIV and antiretroviral treatment, highlighting the benefits of less complex and safer regimens, and the unmet need for effective preventative interventions.
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Affiliation(s)
- Babafemi O. Taiwo
- Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Marie-Hélène Lafeuille
- Analysis Group, Inc, Montréal, QC, Canada,CONTACT Marie-Hélène Lafeuille Analysis Group, Inc, 1190 avenue des Canadiens-de-Montréal, Montréal, QCH3B 0G7, Canada
| | | | | | - Prina Donga
- Janssen Scientific Affairs, LLC, Titusville, NJ, USA
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Human Immunodeficiency Virus Infection-Associated Cardiomyopathy and Heart Failure. J Pers Med 2022; 12:jpm12111760. [PMID: 36573732 PMCID: PMC9695202 DOI: 10.3390/jpm12111760] [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: 09/26/2022] [Revised: 10/11/2022] [Accepted: 10/17/2022] [Indexed: 12/30/2022] Open
Abstract
The landscape of human immunodeficiency virus (HIV) epidemiology and treatment is ever-changing, with the widespread and evolving use of antiretroviral therapy (ART). With timely ART, people living with HIV (PLWH) are nearing the life expectancies and the functionality of the general population; nevertheless, the effects of HIV and ART on cardiovascular health remain under investigation. The pathophysiology of HIV-related cardiomyopathy and heart failure (HF) have historically been attributed to systemic inflammation and changes in cardiometabolic function and cardiovascular architecture. Importantly, newer evidence suggests that ART also plays a role in modulating the process of HIV-related cardiomyopathy and HF. In the short term, newer highly active ART (HAART) seems to have cardioprotective effects; however, emerging data on the long-term cardiovascular outcomes of certain HAART medications, i.e., protease inhibitors, raise concerns about the potential adverse effects of these drugs in the clinical course of HIV-related HF. As such, the traditional phenotypes of dilated cardiomyopathy and left ventricular systolic failure that are associated with HIV-related heart disease are incrementally being replaced with increasing rates of diastolic dysfunction and ischemic heart disease. Moreover, recent studies have found important links between HIV-related HF and other clinical and biochemical entities, including depression, which further complicate cardiac care for PLWH. Considering these trends in the era of ART, the traditional paradigms of HIV-related cardiomyopathy and HF are being called into question, as is the therapeutic role of interventions such as ventricular assist devices and heart transplantation. In all, the mechanisms of HIV-related myocardial damage and the optimal approaches to the prevention and the treatment of cardiomyopathy and HF in PLWH remain under investigation.
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Yang C, Wang D, Ma Y, Liu Z, Guo H, Sang F, Xu Q, Jin Y. Effectors of Hyperlipidemia among HIV/AIDS patients with second-line antiretroviral therapy based on register data. Curr HIV Res 2022; 20:CHR-EPUB-125359. [PMID: 35929632 PMCID: PMC9933044 DOI: 10.2174/1570162x20666220805103411] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/31/2022] [Accepted: 05/05/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE In this study, we aimed to determine the prevalence and effectors of hyperlipidemia among people living with HIV/AIDS (PLWHA) and taking second-line antiretroviral therapy (ART) using registry data in central China. METHODS We conducted a cross-sectional study and collected information of PLWHA on second-line ART during 2018 from two medical registries. Hyperlipidemia was defined according to the 2016 Chinese guidelines for the management of dyslipidemia in adults. Univariate and multivariate logistic regression analyses were performed to explore the influencing factors of hyperlipidemia. We calculated odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS A total of 2886 PLWHA taking second-line ART were included in this study, and 978 (33.9%) had hyperlipidemia. Female patients, those with hyperglycemia, and patients with CD4+ cell counts >500 cells/μL had a higher prevalence of hyperlipidemia with 37.0%, 49.0%, and 41.3%, respectively. Multivariate analysis showed that CD4+ cell count 350-500 cells/μL (OR=1.72, 95% CI: 1.26-2.38), CD4+ cell count >500 cells/μL (OR=2.49, 95% CI: 1.85-3.38), and FPG >6.2 mmol/L (OR=2.08, 95% CI:1.64-2.65) were risk factors for hyperlipidemia. Male sex (OR=0.72, 95% CI: 0.61-0.85) and Hb <110 g/L (OR=0.59, 95% CI: 0.45-0.76) were protective factors against hyperlipidemia. CONCLUSIONS PLWHA on second-line ART had a higher prevalence of hyperlipidemia. Gender, CD4+ cell count, FPG, and hemoglobin were influencing factors of hyperlipidemia.
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Affiliation(s)
- Chunling Yang
- The First Clinical Medical School, Henan University of Chinese Medicine, Zhengzhou, China
| | - Dongli Wang
- The First Clinical Medical School, Henan University of Chinese Medicine, Zhengzhou, China
| | - Yanmin Ma
- Center for AIDS/STD Control and Prevention, Center for Disease Control and Prevention of Henan Province, Zhengzhou, China
| | - Zhibin Liu
- The First Clinical Medical School, Henan University of Chinese Medicine, Zhengzhou, China
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Huijun Guo
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Feng Sang
- Henan Key Laboratory of Viral Diseases Prevention and Treatment of Traditional Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Qianlei Xu
- The First Clinical Medical School, Henan University of Chinese Medicine, Zhengzhou, China
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Yantao Jin
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
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Cummins NW. Metabolic Complications of Chronic HIV Infection: A Narrative Review. Pathogens 2022; 11:pathogens11020197. [PMID: 35215140 PMCID: PMC8879342 DOI: 10.3390/pathogens11020197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/18/2022] [Accepted: 01/28/2022] [Indexed: 02/01/2023] Open
Abstract
As persons who are HIV positive and on suppressive antiretroviral therapy live longer, there is increased incidence and recognition of several metabolic complications of this chronic infection. These metabolic complications of HIV infection can result from the infection itself and/or otherwise effective antiviral treatment and can have significant impacts on morbidity and mortality. Some metabolic complications of HIV infection are preventable but most are modifiable, and therefore, active surveillance and screening are warranted. The purpose of this narrative review is to highlight the most common metabolic complications of chronic HIV infection, associated risk factors, diagnosis, and management.
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Affiliation(s)
- Nathan W Cummins
- Section of Infectious Diseases, Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA
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7
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Grand M, Díaz A, Bia D. Cardiovascular risk prediction equations underestimate risk in people living with HIV: Comparison and cut-point redefinition for 19 cardiovascular risk equations. Curr HIV Res 2022; 20:137-151. [PMID: 35081893 DOI: 10.2174/1570162x20666220126124149] [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: 09/18/2021] [Revised: 11/30/2021] [Accepted: 12/20/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Rates of cardiovascular disease are higher in people living with HIV. Early detection of high-risk subjects (applying cardiovascular risk equations) would allow preventive actions. D:A:D, ASCVD and FRS:CVD equations are the most recommended. However, controversies surround these equations and cut-points, which have the greatest capacity to discriminate high-risk subjects. OBJECTIVES The study aims (i) to assess the association/agreement between cardiovascular risk levels obtained with D:A:D and fifteen other cardiovascular risk equations, (ii) to detect cardiovascular risk equations capability to detect high-risk subjects, and (iii) to specify the optimal cardiovascular risk equation´s cut points for the prediction of carotid plaque presence, as a surrogate of high cardiovascular risk. METHODS 86 adults with HIV were submitted to the clinical, laboratory and cardiovascular risk evaluation (including carotid ultrasound measurements). Cardiovascular risk was evaluated through multiple risk equations (e.g., D.A.D, ASCVD and FRS equations). Association and agreement between equations (Correlation, Bland-Altman, Williams´test) and equations capacity to detect plaque presence (ROC curves, sensitivity, specificity) were evaluated. RESULTS Cardiovascular risk equations showed a significant and positive correlation with plaque presence. Higher high-cardiovascular risk detection capability was obtained for ASCVD and D:A:D. Full D:A:D5y>0.88%, ASCVD>2.80% and FRS:CVD>2.77% correspond to a 80% sensitivity. CONCLUSION All cardiovascular risk equations underestimate the true risk in HIV subjects. The cut-points for high cardiovascular risk were found to vary greatly from recommended in clinical guidelines.
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Affiliation(s)
- Marina Grand
- Instituto de Investigación en Ciencias de la Salud, Facultad de Ciencias de la Salud, Universidad Nacional del Centro de la Provincia de Buenos Aires (UNCPBA), Pringles 4375, Olavarría (7400), Argentina
| | - Alejandro Díaz
- Instituto de Investigación en Ciencias de la Salud, Facultad de Ciencias de la Salud, Universidad Nacional del Centro de la Provincia de Buenos Aires (UNCPBA), Pringles 4375, Olavarría (7400), Argentina
| | - Daniel Bia
- Departamento de Fisiología, Facultad de Medicina, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Universidad de la República. General Flores 2125, 11800 Montevideo, Uruguay
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Diaz A, Grand M, Torrado J, Salazar F, Zócalo Y, Bia D. Aortic Pressure Levels and Waveform Indexes in People Living With Human Immunodeficiency Virus: Impact of Calibration Method on the Differences With Respect to Non-HIV Subjects and Optimal Values. Front Cardiovasc Med 2022; 8:772912. [PMID: 35004887 PMCID: PMC8733318 DOI: 10.3389/fcvm.2021.772912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/30/2021] [Indexed: 12/03/2022] Open
Abstract
Background: There are scarce and controversial data on whether human immunodeficiency virus (HIV) infection is associated with changes in aortic pressure (aoBP) and waveform-derived indexes. Moreover, it remains unknown whether potential differences in aoBP and waveform indexes between people living with HIV (PLWHIV) and subjects without HIV (HIV-) would be affected by the calibration method of the pressure waveform. Aims: To determine: (i) whether PLWHIV present differences in aoBP and waveform-derived indexes compared to HIV- subjects; (ii) the relative impact of both HIV infection and cardiovascular risk factors (CRFs) on aoBP and waveform-derived indexes; (iii) whether the results of the first and second aims are affected by the calibration method. Methods: Three groups were included: (i) PLWHIV (n = 86), (ii) HIV- subjects (general population; n = 1,000) and (iii) a Reference Group (healthy, non-exposed to CRFs; n = 398). Haemodynamic parameters, brachial pressure (baBP; systolic: baSBP; diastolic: baDBP; mean oscillometric: baMBPosc) and aoBP and waveform-derived indexes were obtained. Brachial mean calculated (baMBPcalc=baDBP+[baSBP-baDBP]/3) pressure was quantified. Three waveform calibration schemes were used: systolic-diastolic, calculated (baMBPcalc/baDBP) and oscillometric mean (baMBPosc/baDBP). Results: Regardless of CRFs and baBP, PLWHIV presented a tendency of having lower aoBP and waveform-derived indexes which clearly reached statistical significance when using the baMBPosc/baDBP or baMBPcalc/baDBP calibration. HIV status exceeded the relative weight of other CRFs as explanatory variables, being the main explanatory variable for variations in central hemodynamics when using the baMBPosc/baDBP, followed by the baMBPcalc/baDBP calibration. Conclusions: The peripheral waveform calibration approach is an important determinant to reveal differences in central hemodynamics in PLWHIV.
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Affiliation(s)
- Alejandro Diaz
- Consejo Nacional de Investigaciones Científicas y Técnicas, Instituto de Investigación en Ciencias de la Salud (IICS), Universidad Nacional del Centro de la Provincia de Buenos Aires (UNICEN), Tandil, Argentina
| | - Marina Grand
- Instituto de Investigación en Ciencias de la Salud, Facultad de Ciencias de la Salud, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Argentina.,Hospital Dr. Héctor M. Cura, Olavarría, Argentina
| | - Juan Torrado
- Department of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, New York, NY, United States
| | - Federico Salazar
- Servicio de Cardiología, Hospital Privado de Comunidad, Mar del Plata, Argentina
| | - Yanina Zócalo
- Departamento de Fisiología, Facultad de Medicina, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial, Universidad de la República, Montevideo, Uruguay
| | - Daniel Bia
- Departamento de Fisiología, Facultad de Medicina, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial, Universidad de la República, Montevideo, Uruguay
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Li Y, Wang Z, Xia H, Zhang J. Influence of Statin Therapy on the Incidence of Cardiovascular Events, Cancer, and All-Cause Mortality in People Living With HIV: A Meta-Analysis. Front Med (Lausanne) 2021; 8:769740. [PMID: 34820402 PMCID: PMC8606632 DOI: 10.3389/fmed.2021.769740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 09/29/2021] [Indexed: 01/19/2023] Open
Abstract
Background: Possible influences of statin therapy on the risk of cardiovascular events, cancer, and all-cause mortality in people living with HIV (PLWH) remain unclear. We performed a meta-analysis to systematically evaluate the efficacy of statin in PLWH. Methods: Relevant cohort studies were retrieved via a search of the Medline, the Embase, and the Web of Science databases until June 14, 2021. The data were combined with a random-effects model by incorporating the between-study heterogeneity. Results: A total of 12 multivariate cohort studies with 162,252 participants were eligible for the meta-analysis and 36,253 (22.3%) of them were statin users. Pooled results showed that statin use was independently related to a reduced mortality risk in PLWH [adjusted risk ratio (RR): 0.56, 95% CI: 0.44 to 0.72, p < 0.001, I2 = 41%]. In addition, results of the meta-analysis showed that statin use was not significantly associated with a reduced risk of cardiovascular events in PLWH compared to the statin non-users (RR: 1.14, 95% CI: 0.80 to 1.63, p = 0.48, I2 = 42%). However, statin use was significantly related to a reduced risk of cancer in PLWH (RR: 0.73, 95% CI: 0.58 to 0.93, p = 0.009, I2 = 49%). Sensitivity analyses by excluding one study at a time showed consistent results. No significant publication biases were observed. Conclusion: Statin use is associated with reduced all-cause mortality in PLWH. In addition, statin use is related to a reduced risk of cancer, although the risk of cardiovascular events seems not significantly affected.
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Affiliation(s)
- Yanping Li
- School of Chemistry, Biology and Environment, Institute of Biology and Environmental Engineering, Yuxi Normal University, Yuxi, China
| | - Zhandi Wang
- School of Chemistry, Biology and Environment, Institute of Biology and Environmental Engineering, Yuxi Normal University, Yuxi, China
| | - Haimei Xia
- Center of Chinese Medicine, Yunnan Institute of Traditional Chinese Medicine, Kunming, China
| | - Ju Zhang
- Center of Chinese Medicine, Yunnan Institute of Traditional Chinese Medicine, Kunming, China
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10
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Wu C, Zhao J, Li R, Feng F, He Y, Li Y, Huang R, Li G, Yang H, Cheng G, Chen L, Ma F, Li P, Sun C. Modulation of Antiviral Immunity and Therapeutic Efficacy by 25-Hydroxycholesterol in Chronically SIV-Infected, ART-Treated Rhesus Macaques. Virol Sin 2021; 36:1197-1209. [PMID: 34057681 PMCID: PMC8165512 DOI: 10.1007/s12250-021-00407-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/19/2021] [Indexed: 12/22/2022] Open
Abstract
Cholesterol-25-hydroxylase (CH25H) and its enzymatic product 25-hydroxycholesterol (25HC) exert broadly antiviral activity including inhibiting HIV-1 infection. However, their antiviral immunity and therapeutic efficacy in a nonhuman primate model are unknown. Here, we report that the regimen of 25HC combined with antiretroviral therapy (ART), provides profound immunological modulation towards inhibiting viral replication in chronically SIVmac239-infected rhesus macaques (RMs). Compared to the ART alone, this regimen more effectively controlled SIV replication, enhanced SIV-specific cellular immune responses, restored the ratio of CD4/CD8 cells, reversed the hyperactivation state of CD4+ T cells, and inhibited the secretion of proinflammatory cytokines by CD4+ and CD8+ T lymphocytes in chronically SIV-infected RMs. Furthermore, the in vivo safety and the preliminary pharmacokinetics of the 25HC compound were assessed in this RM model. Taken together, these assessments help explain the profound relationship between cholesterol metabolism, immune modulation, and antiviral activities by 25HC. These results provide insight for developing novel therapeutic drug candidates against HIV-1 infection and other related diseases.
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Affiliation(s)
- Chunxiu Wu
- State Key Laboratory of Respiratory Disease, Guangzhou Institutes of Biomedicine and Health (GIBH), Chinese Academy of Sciences, Guangzhou, 510530, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Jin Zhao
- School of Public Health (Shenzhen), Sun Yat-Sen University, Guangdong, 518107, China
- Key Laboratory of Tropical Disease Control, Sun Yat-Sen University, Ministry of Education, Guangzhou, 514400, China
| | - Ruiting Li
- School of Public Health (Shenzhen), Sun Yat-Sen University, Guangdong, 518107, China
- Key Laboratory of Tropical Disease Control, Sun Yat-Sen University, Ministry of Education, Guangzhou, 514400, China
| | - Fengling Feng
- School of Public Health (Shenzhen), Sun Yat-Sen University, Guangdong, 518107, China
- Key Laboratory of Tropical Disease Control, Sun Yat-Sen University, Ministry of Education, Guangzhou, 514400, China
| | - Yizi He
- State Key Laboratory of Respiratory Disease, Guangzhou Institutes of Biomedicine and Health (GIBH), Chinese Academy of Sciences, Guangzhou, 510530, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yanjun Li
- School of Public Health (Shenzhen), Sun Yat-Sen University, Guangdong, 518107, China
- Key Laboratory of Tropical Disease Control, Sun Yat-Sen University, Ministry of Education, Guangzhou, 514400, China
| | - Runhan Huang
- School of Public Health (Shenzhen), Sun Yat-Sen University, Guangdong, 518107, China
| | - Guangye Li
- Guangdong Landau Biotechnology Co. Ltd, Guangzhou, 510700, China
| | - Heng Yang
- Center for Systems Medicine, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100005, China
- Suzhou Institute of Systems Medicine, Suzhou, 215123, China
| | - Genhong Cheng
- Center for Systems Medicine, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100005, China
- Suzhou Institute of Systems Medicine, Suzhou, 215123, China
- Department of Microbiology, Immunology and Molecular Genetics, University of California, Los Angeles, 90095, USA
| | - Ling Chen
- State Key Laboratory of Respiratory Disease, Guangzhou Institutes of Biomedicine and Health (GIBH), Chinese Academy of Sciences, Guangzhou, 510530, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Feng Ma
- Center for Systems Medicine, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100005, China.
- Suzhou Institute of Systems Medicine, Suzhou, 215123, China.
| | - Pingchao Li
- State Key Laboratory of Respiratory Disease, Guangzhou Institutes of Biomedicine and Health (GIBH), Chinese Academy of Sciences, Guangzhou, 510530, China.
| | - Caijun Sun
- School of Public Health (Shenzhen), Sun Yat-Sen University, Guangdong, 518107, China.
- Key Laboratory of Tropical Disease Control, Sun Yat-Sen University, Ministry of Education, Guangzhou, 514400, China.
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Ucciferri C, Falasca K, Reale M, Tamburro M, Auricchio A, Vignale F, Vecchiet J. Pidotimod and Immunological Activation in Individuals Infected with HIV. Curr HIV Res 2021; 19:260-268. [PMID: 33430735 DOI: 10.2174/1570162x18666210111102046] [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: 05/29/2020] [Revised: 11/18/2020] [Accepted: 11/28/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The improvements in HIV infection therapy and the large availability of antiretroviral drugs have led to an increased survival among HIV infected people, and simultaneously to a raised morbidity and mortality due to not-AIDS-related events in this group compared to the general population. An increased systemic inflammation and a persistent immune activation play a pivotal role in determining high rates of non-AIDS comorbidities. In the last years, many natural or synthetic immunomodulatory molecules acting by different mechanisms have been conceived. Pidotimod is a synthetic dipeptide molecule showing immunomodulatory properties. The aim of this pilot study was to evaluate the effects of Pidotimod supplementation on residual inflammation in HIV infected population. METHODS Forty HIV positive individuals under cART were enrolled: 30 were treated with Pidotimod supplementation (study group) and 10 served as control group (without Pidotimod supplementation). For all participants, Cystatin C, PCR, ESR, microalbuminuria, TNF-α, INF-γ, IL-4, IL-10, IL1β, IL-18 and IL-2 were measured at enrolment (T0), 4 weeks after of Pidotimod supplementation (T1), and 4 weeks after completing supplementation (T2). RESULTS In HIV positive participants treated with Pidotimod, the evaluation of cytokine levels showed that IL-10, IFN gamma, and IL-4 were significantly higher at enrolment compared to the control group. The increase under Pidotimod treatment persisted after supplementation suspension, while the pro-inflammatory cytokines levels were reduced. Salivary IgA also increased during 4 weeks of supplementation and persisted at 4 weeks after completing supplementation. On the other hand, the Cystatin C and microalbuminuria levels decreased over time, at a greater extent the Cystatin C serum levels. CONCLUSION The study findings showed that the HIV population receiving Pidotimod achieved a rebalancing of pro-inflammatory and anti-inflammatory cytokines as well as a significant reduction in cystatin C levels. The treatment further allowed for an increase in salivary IgA levels at all the analyzed times, as a secondary event to a remodulation of the immunological status obtained with pidotimod. This approach could represent a new way to design new intervention strategies aimed at improving the persistent immune activation status in the virologically suppressed HIV population.
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Affiliation(s)
- Claudio Ucciferri
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Italy
| | - Katia Falasca
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Italy
| | - Marcella Reale
- Unit of Immunodiagnostic and Molecular Pathology, Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio", Chieti- Pescara, Italy
| | - Manuela Tamburro
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Antonio Auricchio
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Italy
| | - Francesca Vignale
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Italy
| | - Jacopo Vecchiet
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Italy
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Incidence of dyslipidemia in people with HIV who are treated with integrase inhibitors versus other antiretroviral agents. AIDS 2021; 35:869-882. [PMID: 33443370 DOI: 10.1097/qad.0000000000002811] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To compare the incidence of dyslipidemia in people with HIV receiving integrase inhibitors (INSTI) versus boosted protease inhibitors (PI/b) and nonnucleoside reverse transcriptase inhibitors (NNRTI) within RESPOND consortium of prospective cohorts. METHODS Participants were eligible if they were at least 18 years, without dyslipidemia and initiated or switched to a three-drug antiretroviral therapy (ART)-regimen consisting of either INSTI, NNRTI, or PI/b for the first time, between 1 January 2012 and 31 December 2018. Dyslipidemia was defined as random total cholesterol more than 240 mg/dl, HDL less than 35 mg/dl, triglyceride more than 200 mg/dl, or initiation of lipid-lowering therapy. Poisson regression was used to determine the adjusted incidence rate ratios. Follow-up was censored after 3 years or upon ART-regimen discontinuation or last lipid measurement or 31 December 2019, whichever occurred first. RESULTS Overall, 4577 people with HIV were eligible (INSTI = 66.9%, PI/b = 12.5%, and NNRTI = 20.6%), 1938 (42.3%) of whom were ART-naive. During 1.7 (interquartile range, 0.6-3.0) median years of follow-up, 1460 participants developed dyslipidemia [incidence rate: 191.6 per 1000 person-years, 95% confidence interval (CI) 182.0-201.7]. Participants taking INSTI had a lower incidence of dyslipidemia compared with those on PI/b (adjusted incidence rate ratio 0.71; CI 0.59-0.85), but higher rate compared with those on NNRTI (1.35; CI 1.15-1.58). Compared with dolutegravir, the incidence of dyslipidemia was higher with elvitegravir/cobicistat (1.20; CI 1.00-1.43) and raltegravir (1.24; CI 1.02-1.51), but lower with rilpivirine (0.77; CI 0.63-0.94). CONCLUSION In this large consortium of heterogeneous cohorts, dyslipidemia was less common with INSTI than with PI/b. Compared with dolutegravir, dyslipidemia was more common with elvitegravir/cobicistat and raltegravir, but less common with rilpivirine.
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13
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Ebner B, Vincent L, Grant J, Martinez C. Cardiac Catheterization Procedures in Patients with HIV: A Retrospective Analysis. J Cardiovasc Dev Dis 2021; 8:jcdd8040033. [PMID: 33801600 PMCID: PMC8066790 DOI: 10.3390/jcdd8040033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 11/29/2022] Open
Abstract
With the advent of effective antiretroviral therapies, there has been a decrease in HIV-related mortality, but an increase in non-AIDS-related comorbidities including cardiovascular disease (CVD). We sought to investigate current status of cardiac catheterization (CC) procedures in people with HIV (PWH). This is a retrospective study done at a University Hospital in South Florida between 2017 and 2019. Medical records from 985 PWH indicated that CC was performed in 1.9% of the cases. Of the PWH who underwent CC, 68% were found to have obstructive coronary artery disease (CAD). Among obstructive CAD cases, PCI was performed in 77% and CABG in 21% of cases; 26% had a repeat procedure and 11% died from non-cardiac causes. When comparing PWH who had CC to those who did not, there was a significantly higher rate of statin use (63% vs. 25%, p < 0.015) and a higher prevalence of low ejection fraction (38% vs. 11%, p = 0.004) among those patients who underwent CC. However, there was no significant difference in the prevalence of hypertension (p = 0.13), HbA1c levels (p = 0.32), CD4 count (p = 0.45) nor in undetectable viral load status (p = 0.75) after controlling for age, sex and BMI. Despite the finding of traditional CVD risk factors among PWH, there were no differences in HIV-related factors among patients requiring CC, supporting the importance of optimization of traditional CVD risk factors in this population.
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Affiliation(s)
- Bertrand Ebner
- Department of Internal Medicine, Jackson Health System/University of Miami Miller School of Medicine, Miami, FL 33136, USA; (L.V.); (J.G.)
- Correspondence: ; Tel.: +1-(305)-585-5400
| | - Louis Vincent
- Department of Internal Medicine, Jackson Health System/University of Miami Miller School of Medicine, Miami, FL 33136, USA; (L.V.); (J.G.)
| | - Jelani Grant
- Department of Internal Medicine, Jackson Health System/University of Miami Miller School of Medicine, Miami, FL 33136, USA; (L.V.); (J.G.)
| | - Claudia Martinez
- Department of Cardiovascular Disease, University of Miami Miller School of Medicine, Miami, FL 33136, USA;
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Falasca K, Lanuti P, Ucciferri C, Pieragostino D, Cufaro MC, Bologna G, Federici L, Miscia S, Pontolillo M, Auricchio A, Del Boccio P, Marchisio M, Vecchiet J. Circulating extracellular vesicles as new inflammation marker in HIV infection. AIDS 2021; 35:595-604. [PMID: 33306552 DOI: 10.1097/qad.0000000000002794] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Extracellular vesicles, released by cell pullulation, are surrounded by a phospholipid bilayer and carry proteins as well and genetic material. It has been shown that extracellular vesicles mediate intercellular communication in several conditions, such as inflammation, immunodeficiency, tumor growth, and viral infections. Here, we analyzed circulating levels of extracellular vesicles in order to clarify their role in chronic inflammation mechanisms characterizing HIV patients. METHODS We analyzed and subtyped circulating levels of extracellular vesicles, through a recently developed flow cytometry method. In detail, endothelial-derived extracellular vesicles (CD31+/CD41a-/CD45-, EMVs), extracellular vesicles stemming from leukocytes (CD45+, LMVs) and platelets (CD41a+/CD31+) were identified and enumerated. Moreover, we analyzed the extracellular vesicle protein cargo with proteomic analysis. RESULTS Circulating levels of total extracellular vesicles, EMVs and LMVs were significantly lower in the HIV+ patients than in healthy subjects, whereas platelet-derived extracellular vesicles resulted higher in patients than in the healthy population. Proteomic analysis showed the upregulation of gammaIFN and IL1α, and down-regulation of OSM, NF-kB, LIF, and RXRA signaling resulted activated in this patients. CONCLUSION These data demonstrate, for the first time that HIV infection induces the production of extracellular vesicles containing mediators that possibly feed the chronic inflammation and the viral replication. These two effects are connected as the inflammation itself induces the viral replication. We, therefore, hypothesize that HIV infection inhibits the production of extracellular vesicles that carry anti-inflammatory molecules.
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Affiliation(s)
- Katia Falasca
- Clinic of Infectious Diseases, Department of Medicine and Aging Sciences, University 'G. d'Annunzio' of Chieti-Pescara, Chieti
| | - Paola Lanuti
- Department of Medicine and Aging Sciences, University 'G. d'Annunzio' of Chieti-Pescara
- Center for Advanced Studies and Technology (CAST)
| | - Claudio Ucciferri
- Clinic of Infectious Diseases, Department of Medicine and Aging Sciences, University 'G. d'Annunzio' of Chieti-Pescara, Chieti
| | - Damiana Pieragostino
- Center for Advanced Studies and Technology (CAST)
- Department of Medical, Oral and Biotechnological Sciences
| | - Maria Concetta Cufaro
- Center for Advanced Studies and Technology (CAST)
- Department of Pharmacy, University 'G. d'Annunzio' of Chieti-Pescara, Chieti, Italy
| | - Giuseppina Bologna
- Department of Medicine and Aging Sciences, University 'G. d'Annunzio' of Chieti-Pescara
- Center for Advanced Studies and Technology (CAST)
| | - Luca Federici
- Center for Advanced Studies and Technology (CAST)
- Department of Medical, Oral and Biotechnological Sciences
| | - Sebastiano Miscia
- Department of Medicine and Aging Sciences, University 'G. d'Annunzio' of Chieti-Pescara
- Center for Advanced Studies and Technology (CAST)
| | - Michela Pontolillo
- Clinic of Infectious Diseases, Department of Medicine and Aging Sciences, University 'G. d'Annunzio' of Chieti-Pescara, Chieti
| | - Antonio Auricchio
- Clinic of Infectious Diseases, Department of Medicine and Aging Sciences, University 'G. d'Annunzio' of Chieti-Pescara, Chieti
| | - Piero Del Boccio
- Center for Advanced Studies and Technology (CAST)
- Department of Pharmacy, University 'G. d'Annunzio' of Chieti-Pescara, Chieti, Italy
| | - Marco Marchisio
- Department of Medicine and Aging Sciences, University 'G. d'Annunzio' of Chieti-Pescara
- Center for Advanced Studies and Technology (CAST)
| | - Jacopo Vecchiet
- Clinic of Infectious Diseases, Department of Medicine and Aging Sciences, University 'G. d'Annunzio' of Chieti-Pescara, Chieti
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A Meta-Analysis of Different Types of Cardiac Adipose Tissue in HIV Patients. BIOMED RESEARCH INTERNATIONAL 2020; 2020:8234618. [PMID: 33376740 PMCID: PMC7746457 DOI: 10.1155/2020/8234618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/31/2020] [Accepted: 11/25/2020] [Indexed: 12/15/2022]
Abstract
Background Antiretroviral therapy transformed HIV infection into a chronic disease but accelerated cardiovascular disease (CVD). Both of epicardial adipose tissue (EAT) and pericardial fat (PCF) have close relationships with CVD. The associations between these two cardiac adipose tissue and HIV are unclear. Methods Eligible studies were searched in PubMed, Embase, Web of Science, and Scopus from database inception to March 24, 2020. The summarized standard mean difference (SMD) or weighted mean difference (WMD) with 95% confidence intervals (CIs) was used to assess the association between EAT/PCF and HIV. Subgroup analysis was performed based on EAT types. Trial sequential analysis was conducted to estimate whether the evidence of the results is sufficient. Results In total, 2561 HIV patients and 1767 non-HIV participants were included. Compared to the control group, EAT was significantly higher in the HIV overall group and subgroup with EAT thickness (SMD = 0.59, 95% CI: 0.24-0.95, P = 0.001; SMD = 1.10, 95% CI: 0.41-1.79, P = 0.002); however, the EAT volume and PCF volume were unchanged in the HIV group (SMD = 0.16, 95% CI: -0.07-0.39, P = 0.169; WMD = 10.78, 95% CI: -14.11-35.67, P = 0.396). Trial sequential analysis indicated that the available samples were sufficient in the HIV overall group and subgroup with EAT thickness, and more studies are needed for EAT volume and PCF volume. Conclusions EAT thickness was significantly higher in patients with HIV. The association between EAT/PCF volume and HIV needs more studies to confirm.
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Grand M, Diaz A, Bia D. [Cardiovascular risk calculators for people living with human immunodeficiency virus]. HIPERTENSION Y RIESGO VASCULAR 2020; 37:181-193. [PMID: 32709573 DOI: 10.1016/j.hipert.2020.06.004] [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: 04/16/2020] [Revised: 06/01/2020] [Accepted: 06/26/2020] [Indexed: 10/23/2022]
Abstract
The increasing access and efficacy of antiretroviral therapy has allowed people living with human immunodeficiency virus to achieve a life expectancy similar to that of the general population. However, this goal may be affected by the increased risk of cardiovascular disease in this group. This risk is multifactorial, involving the high prevalence of traditional risk factors, the development of a pro-inflammatory state related to chronic infection, and the use of antiretroviral drugs with an adverse metabolic profile. In daily practice, in order to estimate this risk and guide medical decision-making, different calculators are available. These are based on data from population cohorts, many of them from human immunodeficiency virusnegative subjects. The main aim of this review is to describe the epidemiology of cardiovascular disease in people living with human immunodeficiency virus, the available risk calculators and their use.
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Affiliation(s)
- M Grand
- Instituto de Investigación en Ciencias de la Salud, Facultad de Ciencias de la Salud, Universidad Nacional del Centro de la Provincia de Buenos Aires (UNCPBA), Olavarría, Argentina.
| | - A Diaz
- Instituto de Investigación en Ciencias de la Salud, Facultad de Ciencias de la Salud, Universidad Nacional del Centro de la Provincia de Buenos Aires (UNCPBA), Olavarría, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET, Centro Científico Tecnológico Tandil). Instituto de Investigación en Ciencias de la Salud, Facultad de Ciencias de la Salud, Universidad Nacional del Centro de la Provincia de Buenos Aires (UNCPBA), Tandil, Argentina
| | - D Bia
- Departamento de Fisiologia, Facultad de Medicina, Universidad de la Republica, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Universidad de la República General Flores, Montevideo, Uruguay
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Ruiz-Padilla AJ, Ruiz-Noa Y, Del Rocio Ibarra-Reynoso L, Lazo-de-la-Vega-Monroy ML, Alonso-Castro AJ, Sánchez-Barajas M, Alvarez-Alvarez RM, Del Carmen Preciado-Puga M. FGF21 and its Relationship with Inflammatory and Metabolic Parameters in HIV Patients after Antiretroviral Treatment. Curr HIV Res 2020; 18:308-314. [PMID: 32684151 DOI: 10.2174/1570162x18666200719235625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 06/19/2020] [Accepted: 07/30/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Fibroblast Growth Factor 21 (FGF21) serum levels are associated with insulin resistance and metabolic syndrome in HIV patients. OBJECTIVE To quantify FGF21 levels in HIV patients using antiretroviral therapy (ART) and to analyze a possible association between serum FGF21 levels and lipid profile, levels of proinflammatory cytokines, and atherogenic risk factors. MATERIALS AND METHODS Twenty patients with HIV infection, who received ART in a scheme consisting of Tenofovir/Emtricitabine+Lopinavir/Ritonavir, were enrolled in this study. The serum levels of FGF21, inflammatory parameters (IL-6 and IL-1β), glucose, cholesterol, triglycerides, and insulin were determined at baseline and after 36 weeks of treatment. The homeostatic model assessment for insulin resistance (HOMA-IR) and the atherogenic risk factor were also calculated. RESULTS After 36 weeks, serum FGF21 levels decreased significantly (p=0.011), whereas IL-6 levels (r=0.821, p=0.0001) and the CD4+ T cell count (r=0.446, p=0.048), showed a positive correlation with the decrease in FGF21 levels. There was an increase in total cholesterol (r=-0.483, p=0.031), LDL (r=-0.496, p=0.026), VLDL (r=-0.320, p=0.045), and the atherogenic index factor (r=-0.539, p=0.014), these values showed a negative correlation with FGF21 levels. CONCLUSION The decrease of serum FGF21 levels due to ART is associated with the alteration in lipid profile and an increased risk for cardiovascular diseases. These variations are predictors of inflammatory status in HIV patients using antiretroviral therapy.
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Affiliation(s)
- Alan Joel Ruiz-Padilla
- Departamento de Farmacia, División de Ciencias Exactas e Ingenierías, Universidad de Guanajuato, Campus
Guanajuato- Guanajuato, Guanajuato, México
| | - Yeniley Ruiz-Noa
- Departamento de Ciencias Médicas División de Ciencias de la Salud, Universidad de Guanajuato, Campus León, León, Guanajuato, México
| | - Lorena Del Rocio Ibarra-Reynoso
- Departamento de Ciencias Médicas División de Ciencias de la Salud, Universidad de Guanajuato, Campus León, León, Guanajuato, México
| | | | - Angel Josabad Alonso-Castro
- Departamento de Farmacia, División de Ciencias Exactas e Ingenierías, Universidad de Guanajuato, Campus
Guanajuato- Guanajuato, Guanajuato, México
| | - Mauricio Sánchez-Barajas
- Departamento de Ciencias Médicas División de Ciencias de la Salud, Universidad de Guanajuato, Campus León, León, Guanajuato, México,Departamento de Medicina Interna, Hospital General de Zona/MF 21, León, Guanajuato, México
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Effect of Omega-3 Polyunsaturated Fatty Acids Treatment on Lipid Pattern of HIV Patients: A Meta-Analysis of Randomized Clinical Trials. Mar Drugs 2020; 18:md18060292. [PMID: 32492789 PMCID: PMC7345035 DOI: 10.3390/md18060292] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/20/2020] [Accepted: 05/25/2020] [Indexed: 12/29/2022] Open
Abstract
Even though omega-3 polyunsaturated fatty acids (PUFAs) seem to be effective in the treatment of human immunodeficiency virus (HIV)-associated dyslipidemia, their impact is still debated. For this reason, our aim was to perform a meta-analysis of the clinical evidence available to date. A systematic literature search was conducted in order to identify published clinical trials assessing the effect of PUFAs treatment on serum lipoproteins, and its safety profile. The effect sizes for lipid changes were expressed as mean difference (MD) and 95% confidence interval (CI). For safety analysis, odd ratios and the 95% CI were calculated with the Mantel-Haenszel method. Data were pooled from nine clinical studies comprising overall 578 HIV-affected subjects. Meta-analysis of the data suggested that omega-3 PUFAs significantly reduced triglycerides (TG) (MD = -1.04, 95% CI: -1.5, -0.58 mmol/L, p < 0.001), while increasing high-density lipoprotein cholesterol (MD = 0.36, 95% CI: 0.12, 0.61 mmol/L, p = 0.004), without affecting serum levels of total cholesterol, very-low- and low-density lipoprotein cholesterol, and apolipoprotein B and A1. Change in TG was significantly associated with eicosapentaenoic acid administered via daily dose. PUFA treatment did not lead to an increased risk of adverse events. In conclusion, PUFAs are safe and exert a significant plasma lipid improving effect in HIV-positive patients.
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