scholarly journals Impact of switching to TAF/FTC/RPV, TAF/FTC/EVG/cobi and ABC/3TC/DTG on cardiovascular risk and lipid profile in people living with HIV: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andrea Giacomelli ◽  
Federico Conti ◽  
Laura Pezzati ◽  
Letizia Oreni ◽  
Anna Lisa Ridolfo ◽  
...  

Abstract Background We aimed to assess the overall cardiovascular and metabolic effect of the switch to three different single tablet regimens (STRs) [tenofovir alafenamide/emtricitabine/rilpivirine (TAF/FTC/RPV), TAF/FTC/elvitegravir/cobi (TAF/FTC/EVG/cobi) and ABC/lamivudine/dolutegravir (ABC/3TC/DTG)] in a cohort of people living with HIV/AIDS (PLWH) under effective ART. Methods All PLWH aged above 18 years on antiretroviral treatment with an HIV-RNA < 50 cp/mL at the time of the switch to TAF/FTC/RPV, TAF/FTC/EVG/cobi and ABC/3TC/DTG were retrospectively included in the analysis. Framingham risk score modification after 12 months from the switch such as lipid profile and body weight modification were assessed. The change from baseline to 12 months in mean cardiovascular risk and body weight in each of the STR’s group were assessed by means of Wilcoxon signed-rank test whereas a mixed regression model was used to assess variation in lipid levels. Results Five-hundred and sixty PLWH were switched to an STR regimen of whom 170 (30.4%) to TAF/FTC/EVG/cobi, 191 (34.1%) to TAF/FTC/RPV and 199 (35.5%) to ABC/3TC/DTG. No difference in the Framingham cardiovascular risk score was observed after 12 months from the switch in each of the STR’s groups. No significant overtime variation in mean total cholesterol levels from baseline to 12 months was observed for PLWH switched to ABC/3TC/DTG [200 (SD 38) mg/dl vs 201 (SD 35) mg/dl; p = 0.610] whereas a significant increment was observed in PLWH switched to TAF/FTC/EVG/cobi [192 (SD 34) mg/dl vs 208 (SD 40) mg/dl; p < 0.0001] and TAF/FTC/RPV [187 (SD 34) mg/dl vs 195 (SD 35) mg/dl; p = 0.027]. In addition, a significant variation in the mean body weight from baseline to 12 months was observed in PLWH switched to TAF/FTC/EVG/cobi [72.2 (SD 13.5) kilograms vs 74.6 (SD 14.3) kilograms; p < 0.0001] and TAF/FTC/RPV [73.4 (SD 11.6) kilograms vs 75.6 (SD 11.8) kilograms; p < 0.0001] whereas no difference was observed in those switched to ABC/3TC/DTG [71.5 (SD 12.8) kilograms vs 72.1 (SD 12.6) kilograms; p = 0.478]. Conclusion No difference in the cardiovascular risk after 1 year from the switch to these STRs were observed. PLWH switched to TAF/FTC/EVG/cobi and TAF/FTC/RPV showed an increase in total cholesterol levels and body weight 12 months after the switch.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pierre-Emmanuel Plum ◽  
Nathalie Maes ◽  
Anne-Sophie Sauvage ◽  
Frédéric Frippiat ◽  
Christelle Meuris ◽  
...  

Abstract Background As cardiovascular diseases represent the main cause of non-AIDS related death in people living with HIV (PLWH) with undetectable viral load, we evaluated lipid profile, weight gain and calculated cardiovascular risk change after switching from tenofovir disoproxil fumarate (TDF)-based regimens to tenofovir alafenamide (TAF)-based regimens. Methods For this retrospective study, we selected HIV-infected patients with suppressed viral load who fitted in one of the two groups below: First group (TDF/TDF): Patients treated continuously with TDF-based regimens. Second group (TDF/TAF): Patients treated with TDF-regimens during at least 6 months then switched to TAF-regimens while maintaining other drugs unchanged. Available data included date of birth, gender, ethnicity, lymphocyte T CD4+ count, weight, height, blood pressure, current/ex/non-smoker, diabetes mellitus, familial cardiovascular event, lipid profile, duration and nature of antiretroviral therapy. Lipid parameters, weight and calculated cardiovascular risk using 5-year reduced DAD score algorithm [Friis-Møller et al. in Eur J Cardiovasc Prev Rehabil 17:491–501, 2010] were analyzed in each groups. Results Switching from TDF to TAF resulted in a significant increase in triglycerides levels, total cholesterol and HDL cholesterol. LDL cholesterol and total cholesterol/HDL ratio did not show significant changes. Calculated cardiovascular risk increased after switch from TDF- to TAF-based therapy. Conclusions Together with favorable outcomes at the bone and kidney levels, potential negative impact of TAF on lipid profile should be included in the reflection to propose the most appropriate and tailored ARV treatment.


Author(s):  
Jose-Maria Jiménez ◽  
Miguel-Angel Carbajo ◽  
María López ◽  
María-José Cao ◽  
Jaime Rúiz-Tovar ◽  
...  

Morbid obesity has a direct impact on the development of cardiovascular disease. One-anastomosis gastric bypass (OAGB) is an effective surgical technique for the control of body weight and the reduction of cardiovascular risk. This work examines the change in weight loss, lipid profile and cardiovascular risk in 100 patients (71 women, 29 men), mean age 42.61 ± 11.33 years at 3, 6, 9, 12, 18 and 24 months after OAGB. At 24 months post-surgery, mean body weight was significantly reduced compared to pre-operative values (116.75 ± 22.19 kg vs. 69.66 ± 13.07 kg), as were mean total cholesterol (201.86 ± 44.60 mg/dL vs. 172.99 ± 32.26 mg/dL), LDL (Low-Density Lipoprotein) cholesterol (126.90 ± 39.81 mg/dL vs. 96.28 ± 26.99 mg/dL), triglycerides (138.05 ± 78.45 mg/dL vs. 76.04 ± 30.34 mg/dL) and cardiovascular risk (total cholesterol/HDL (High-Density Lipoprotein) cholesterol: 4.32 ± 1.24 vs. 2.93 ± 0.71), while the mean HDL cholesterol concentration was significantly higher (49.09 ± 14.16 mg/dL vs. 61.98 ± 14.86 mg/dL) (all p < 0.001). In conclusion, OAGB surgery led to significant reductions in body weight, a significant improvement in the lipid profile, and a reduction in cardiovascular risk.


2021 ◽  
Vol 11 (4) ◽  
pp. 502
Author(s):  
Antonio Reia ◽  
Martina Petruzzo ◽  
Fabrizia Falco ◽  
Teresa Costabile ◽  
Matteo Conenna ◽  
...  

Background. Cardiovascular comorbidities have been associated with cognitive decline in the general population. Objectives. To evaluate the associations between cardiovascular risk and neuropsychological performances in MS. Methods. This is a retrospective study, including 69 MS patients. For all patients, we calculated the Framingham risk score, which provides the 10-year probability of developing macrovascular disease, using age, sex, diabetes, smoking, systolic blood pressure, and cholesterol levels as input variables. Cognitive function was examined with the Brief International Cognitive Assessment for MS (BICAMS), including the Symbol Digit Modalities Test (SDMT), the California Verbal Learning Test-II (CVLT-II), and the Brief Visuospatial Memory Test-Revised (BVMT-R). Results. Each point increase of the Framingham risk score corresponded to 0.21 lower CVLT-II score. Looking at Framingham risk score components, male sex and higher total cholesterol levels corresponded to lower CVLT scores (Coeff = −8.54; 95%CI = −15.51, −1.57; and Coeff = −0.11; 95%CI = −0.20, −0.02, respectively). No associations were found between cardiovascular risk and SDMT or BVMT-R. Conclusions. In our exploratory analyses, cardiovascular risk was associated with verbal learning dysfunction in MS. Lifestyle and pharmacological interventions on cardiovascular risk factors should be considered carefully in the management of MS, given the possible effects on cognitive function.


HIV Medicine ◽  
2021 ◽  
Author(s):  
Jun Yong Choi ◽  
Grace Chung Yan Lui ◽  
Chia‐Te Liao ◽  
Chia‐Jui Yang

Author(s):  
Amit C. Achhra ◽  
Asya Lyass ◽  
Leila Borowsky ◽  
Milana Bogorodskaya ◽  
Jorge Plutzky ◽  
...  

Author(s):  
E. Sovia ◽  
W. Ratwita ◽  
D. Wijayanti ◽  
D. R. Novianty

Objective: The aim of this study was to investigate hypoglycemic and hypolipidemic effects of Annona muricata leaf ethanol extract. This study also investigated phytochemical analysis of the extract and improvement in the islet of Langerhans.Methods: Hypoglycemic and hypolipidemic effects were evaluated using alloxan induced diabetic rats. Twenty-five Wistar rats devided into five groups, that are normal group, control group that induced by alloxan 125 mg/kg body weight and given CMC (carboxymethyl cellulose), and three treatment group that induced by alloxan and given Annona muricata leaf ethanol extract (AMLEE) with 50, 100 and 200 mg/kg body weight. Blood glucose and total cholesterol levels were measured before and after alloxan induction, and 21 d after AMLEE treatment. At the end of the study, all of the animals experiment were sacrificed for histopathological examination.Results: Phytochemical analysis revealed that flavonoids, tannins, saponins, phytosterols and phenols were present in ethanol extract of Annona muricata L. leaf. At the end of the study, blood glucose and total cholesterol levels in all AMLEE treated group were decreased significantly (p<0.05). Final blood glucose level in the groups that given AMLEE 50 mg/kg body weight (86.7±14.6 mg/dl) was almost the same with that of the normal group (91.25±28.38 mg/dl). The result of the histopathological examination is not showed an improvement of the islet of Langerhans in AMLEE treated groups.Conclusion: In conclusion, the ethanol extract of Annona muricata L. leaf have hypoglycemic and hypolipidemic effects. However, there was no improvement in the islet of Langerhans damage.


Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2047
Author(s):  
Davide Fiore Bavaro ◽  
Paola Laghetti ◽  
Mariacristina Poliseno ◽  
Nicolò De Gennaro ◽  
Francesco Di Gennaro ◽  
...  

The quality of life of people living with HIV (PLWH) has remarkably increased thanks to the introduction of combined antiretroviral therapy. Still, PLWH are exposed to an increased risk of cardiovascular diseases, diabetes, chronic kidney disease, and liver disease. Hence, the purpose of this review is to summarize the current knowledge about diagnosis and nutritional management with specific indication of macro and micronutrients intake for the main comorbidities of PLWH. In fact, a prompt diagnosis and management of lifestyle behaviors are fundamental steps to reach the “fourth 90”. To achieve an early diagnosis of these comorbidities, clinicians have at their disposal algorithms such as the Framingham Score to assess cardiovascular risk; transient elastography and liver biopsy to detect NAFLD and NASH; and markers such as the oral glucose tolerance test and GFR to identify glucose impairment and renal failure, respectively. Furthermore, maintenance of ideal body weight is the goal for reducing cardiovascular risk and to improve diabetes, steatosis and fibrosis; while Mediterranean and low-carbohydrate diets are the dietetic approaches proposed for cardioprotective effects and for glycemic control, respectively. Conversely, diet management of chronic kidney disease requires different nutritional assessment, especially regarding protein intake, according to disease stage and eventually concomitant diabetes.


2020 ◽  
Author(s):  
Chia Goh ◽  
Henry Mwandumba ◽  
Alicja Rapala ◽  
Willard Tingao ◽  
Irene Sheha ◽  
...  

HIV is associated with increased cardiovascular disease (CVD) risk. Despite the high prevalence of HIV in low income subSaharan Africa, there are few data on the assessment of CVD risk in the region. In this study, we aimed to compare the utility of existing CVD risk scores in a cohort of Malawian adults, and assess to what extent they correlate with established markers of endothelial damage: carotid intima media thickness (IMT) and pulse wave velocity (PWV). WHO/ISH, SCORE, FRS, ASCVD, QRISK2 and D:A:D scores were calculated for 279 Malawian adults presenting with HIV and low CD4. Correlation of the calculated 10year CVD risk score with IMT and PWV was assessed using Spearmans rho. The median (IQR) age of patients was 37 (31 to 43) years and 122 (44%) were female. Median (IQR) blood pressure was 120/73mmHg (108/68 to 128/80) and 88 (32%) study participants had a new diagnosis of hypertension. The FRS and QRISK2 scores included the largest number of participants in this cohort (96% and 100% respectively). D:A:D, a risk score specific for people living with HIV, identified more patients in moderate and high risk groups. Although all scores correlated well with physiological markers of endothelial damage, FRS and QRISK2 correlated most closely with both IMT [r2 0.51, p<0.0001 and r2 0.47, p<0.0001 respectively] and PWV [r2 0.47, p<0.0001 and r2 0.5, p<0.0001 respectively]. Larger cohort studies are required to adapt and validate risk prediction scores in this region, so that limited healthcare resources can be effectively targeted.


2018 ◽  
Vol 54 (1) ◽  
pp. 16 ◽  
Author(s):  
Wiwik Werdiningsih ◽  
Suhartati Suhartati

Red dragon fruit (Hylocereus polyrhizus) peel contains anthocyanin, fiber and vitamin C, so it can be used to improve lipid profile in dyslipidemia. The peel of the dragon fruit is not durable, so in this study we used freeze-dried dragon fruit peel. The aim of this study was to prove that the administration of the red dragon fruit peel in a dose of 0.72 g/200 g BW, 1.08 g/200 g BW, and 1.44 g/200 g BW of rat per day for 28 days may improve lipid profile in male wistar strain white rats with high-fat diet. Lipid profiles were studied by examining of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. This was a pure experimental study using randomized post test only control group design. This study used experimental animal of 30 male wistar strain white rats which were divided into five groups. Measurements of total, LDL, and HDL cholesterol levels were done by CHOD-PAP method, while triglyceride level was measured with GPO-PAP method. Data were analyzed statistically by One Way Anova test. The results of this study indicated that giving the peel of red dragon fruit as much as 0.72 g lowered total cholesterol levels, 1.08 g lowered total and LDL cholesterol levels, and 1.44 g lowered total cholesterol, LDL cholesterol, triglyceride levels, and raised HDL cholesterol level. Red dragon fruit peel can be used alternatively to improve lipid profile in dyslipidemia.


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