Mild renal impairment is associated with calcified plaque parameters assessed by computed tomography angiography in people living with HIV

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

Download Full-text

Higher risk of renal impairment associated with tenofovir use amongst people living with HIV in India: A comparative cohort analysis between Western India and United Kingdom

BMC Infectious Diseases ◽

10.1186/1471-2334-14-173 ◽

2014 ◽

Vol 14 (1) ◽

Cited By ~ 10

Author(s):

Sanjay N Pujari ◽

Colette Smith ◽

Abhimanyu Makane ◽

Mike Youle ◽

Margaret Johnson ◽

...

Keyword(s):

United Kingdom ◽

Renal Impairment ◽

Cohort Analysis ◽

Western India ◽

People Living With Hiv ◽

Living With Hiv

Download Full-text

Prevalence of and Risk Factors for Low Bone Mineral Density Assessed by Quantitative Computed Tomography in People Living With HIV and Uninfected Controls

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0000000000002245 ◽

2020 ◽

Vol 83 (2) ◽

pp. 165-172

Author(s):

Magda T. Thomsen ◽

Yaffah L. Wiegandt ◽

Marco Gelpi ◽

Andreas D. Knudsen ◽

Andreas Fuchs ◽

...

Keyword(s):

Risk Factors ◽

Computed Tomography ◽

Bone Mineral Density ◽

Bone Mineral ◽

Quantitative Computed Tomography ◽

People Living With Hiv ◽

Mineral Density ◽

Low Bone Mineral Density ◽

Living With Hiv

Download Full-text

INCIDENCE AND RISK FACTORS OF RENAL IMPAIRMENT IN HIV-1 INFECTED PATIENTS RECEIVING TENOFOVIR BASED ANTIRETROVIRAL THERAPY IN A SOUTH INDIAN HOSPITAL

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2017v9i5.15313 ◽

2017 ◽

Vol 9 (5) ◽

pp. 152

Author(s):

A. Pramod Kumar ◽

G. Parthasarathi ◽

A. P. Sudheer ◽

S. N. Mothi ◽

V. H. T. Swamy ◽

...

Keyword(s):

Risk Factors ◽

Renal Impairment ◽

Real Life ◽

Transcriptase Inhibitor ◽

People Living With Hiv ◽

South Indian ◽

Severe Impairment ◽

Living With Hiv ◽

Reverse Transcriptase Inhibitor ◽

Hiv 1

Objective: To identify the incidence and risk factors of tenofovir (TDF) induced nephrotoxicity among People Living with HIV/AIDS (PLHA) receiving TDF-based anti-retroviral therapy (ART) in a South Indian Hospital.Methods: A retrospective cohort study was conducted among HIV-infected ART naïve patients taking TDF as part of either a first-line or second-line ART between July 2013 and June 2015 at Asha kirana Hospital Mysore, India.Results: A total of 380 patients have been initiated on TDF-based ART. Out of these, 335 patients were on tenofovir+lamivudine+efavirenz, 30 patients were on the tenofovir+lamivudine+nevirapine regimen and 25 patients were on tenofovir+lamivudine+atazanavir/ritonavir regimen. Renal impairment was documented for 35 patients with 9.21% incidence. 34% of renal impaired patients had a severe impairment with eGFR<30 ml/min. Elderly patients (>61 y) had higher chances of developing TDF toxicity compared to adult patients (P=0.0018). Other possible risk factors for TDF-induced renal impairment was CD4>200 (P=0.003). TDF was withdrawn and substituted with Nucleoside Reverse Transcriptase Inhibitor (NRTI) drug following the diagnosis of renal impairment.Conclusion: TDF-associated renal impairment was not uncommon in real-life practice and considered as a frequent complication during treatment with TDF. Risk factors for developing renal impairment include increasing age and CD4>200 cells.

Download Full-text

Abstract 15473: Effect of Statins on Coronary Plaque Progression Assessed by Serial Coronary Computed Tomography Angiography

Circulation ◽

10.1161/circ.142.suppl_3.15473 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Suraj Dahal ◽

Suvasini Lakshmanan ◽

Khadije Ahmad ◽

Vahid Rezvanizadeh ◽

Ahmed K Ghanem ◽

...

Keyword(s):

Computed Tomography ◽

Statin Therapy ◽

Computed Tomography Angiography ◽

Coronary Plaque ◽

Analysis Of Covariance ◽

Plaque Burden ◽

Plaque Morphology ◽

Plaque Progression ◽

Fibrous Plaque ◽

Calcified Plaque

Introduction: Statins stabilize coronary plaques and reduce clinical events. However, it is unclear how statins change the total plaque burden and plaque morphology. Hypothesis: We aimed at investigating whether statin users have less coronary plaque progression compared to non-statins users. Methods: We identified 243 subjects undergoing serial computed tomography angiography, 163 taking statins and 80 who are not. Coronary plaque (total, calcified, non-calcified including fibrous, fibrous-fatty and low-attenuation plaque (LAP)) volume was measured using semi-automated plaque software (Qangio, Medis) and its change overtime between statins users and non-statins users was evaluated using Analysis of Covariance (ANCOVA) modeling adjusted for age, gender, diabetic status, presence of hypertension, past smoking use, and baseline plaque levels. Results: Subjects on statin therapy had higher body mass index, were more likely to be diabetic, had hyperlipidemia, and were past smokers. Median coronary artery calcium score was significantly lower in the statin group; p<0.034. Driven primarily by changes in fibrous plaque, those on statin therapy showed 25% less total plaque (P=0.013) and 31% less total non-calcified plaque (P=0.006) at follow-up than non-statin users. Conclusions: The current study indicates that statin use is associated with less progression of total plaque and total non-calcified plaque burden.

Download Full-text

Lung Cancer Screening with Chest Computed Tomography in People Living with HIV: A Review by the Multidisciplinary CANCERVIH Working Group

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2016.06.026 ◽

2016 ◽

Vol 11 (10) ◽

pp. 1644-1652 ◽

Cited By ~ 7

Author(s):

Alain Makinson ◽

Vincent Le Moing ◽

Jacques Reynes ◽

Tristan Ferry ◽

Armelle Lavole ◽

...

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

Cancer Screening ◽

Working Group ◽

Lung Cancer Screening ◽

People Living With Hiv ◽

Chest Computed Tomography ◽

Living With Hiv

Download Full-text

Incidental findings in elderly people living with HIV undergoing computed tomography coronary artery calcium scoring

AIDS ◽

10.1097/qad.0000000000002536 ◽

2020 ◽

Vol 34 (10) ◽

pp. 1573-1575

Author(s):

Mimie Chirwa ◽

Maria Mazzitelli ◽

Branca Pereira ◽

Ana Milinkovic ◽

Muramatsu Takashi ◽

...

Keyword(s):

Computed Tomography ◽

Coronary Artery ◽

Elderly People ◽

Coronary Artery Calcium ◽

Incidental Findings ◽

People Living With Hiv ◽

Calcium Scoring ◽

Coronary Artery Calcium Scoring ◽

Living With Hiv

Download Full-text

Prevalence and Evolution of Renal Impairment in People Living With HIV in Rural Tanzania

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy072 ◽

2018 ◽

Vol 5 (4) ◽

Cited By ~ 1

Author(s):

Herry Mapesi ◽

Aneth V Kalinjuma ◽

Alphonce Ngerecha ◽

Fabian Franzeck ◽

Christoph Hatz ◽

...

Keyword(s):

Logistic Regression ◽

Renal Impairment ◽

Older Age ◽

Cd4 Count ◽

Noncommunicable Disease ◽

World Health ◽

People Living With Hiv ◽

Rural Tanzania ◽

Living With Hiv

Abstract Background We assessed the prevalence, incidence, and predictors of renal impairment among people living with HIV (PLWHIV) in rural Tanzania. Methods In a cohort of PLWHIV aged ≥15 years enrolled from January 2013 to June 2016, we assessed the association between renal impairment (estimated glomerural filtration rate < 90 mL/min/1.73 m2) at enrollment and during follow-up with demographic and clinical characteristcis using logistic regression and Cox proportional hazards models. Results Of 1093 PLWHIV, 172 (15.7%) had renal impairment at enrollment. Of 921 patients with normal renal function at baseline, 117 (12.7%) developed renal impairment during a median follow-up (interquartile range) of 6.2 (0.4–14.7) months. The incidence of renal impairment was 110 cases per 1000 person-years (95% confidence interval [CI], 92–132). At enrollment, logistic regression identified older age (adjusted odds ratio [aOR], 1.79; 95% CI, 1.52–2.11), hypertension (aOR, 1.84; 95% CI, 1.08–3.15), CD4 count <200 cells/mm3 (aOR, 1.80; 95% CI, 1.23–2.65), and World Health Organization (WHO) stage III/IV (aOR, 3.00; 95% CI, 1.96–4.58) as risk factors for renal impairment. Cox regression model confirmed older age (adjusted hazard ratio [aHR], 1.85; 95% CI, 1.56–2.20) and CD4 count <200 cells/mm3 (aHR, 2.05; 95% CI, 1.36–3.09) to be associated with the development of renal impairment. Conclusions Our study found a low prevalence of renal impairment among PLWHIV despite high usage of tenofovir and its association with age, hypertension, low CD4 count, and advanced WHO stage. These important and reassuring safety data stress the significance of noncommunicable disease surveillance in aging HIV populations in sub-Saharan Africa.

Download Full-text