Arterial stiffness is associated with oxidative stress and endothelial activation among persons with treated HIV in Zambia

Background: Cardiovascular disease (CVD) prevalence is rising among persons with HIV (PLWH) in sub-Saharan Africa. Oxidative stress and endothelial activation, resulting in reduced vascular compliance, are contributors to CVD risk. However, there is a paucity of vascular health data in this population.Objectives: To assess the relationships of oxidative stress and endothelial activation with vascular stiffness among PLWH.Method: Fifty-four PLWH on antiretroviral therapy 5 years and 57 HIV-negative controls, all aged 18–45 years, were enrolled from the University Teaching Hospital, Lusaka, Zambia. Oxidative stress was measured by nitrotyrosine, a peroxynitrite biomarker, and endothelial activation by soluble intercellular adhesion molecule-1 (sICAM-1) plasma levels. Vascular compliance was measured using carotid-radial pulse wave velocity (crPWV) and arterial stiffness index (crASI).Results: PLWH had higher sICAM-1 levels (median 345 ng/mL) compared to controls (275 ng/mL, p 0.01), as well as higher nitrotyrosine levels (297 versus 182 nM; p = 0.02). Median crPWV was similar between the groups, but PLWH had higher crASI (2.4 versus 2.2 cm/ms; p 0.05). After adjusting for age, fat mass, and blood pressure, the estimated effect of a one unit increase in nitrotyrosine on crPWV were twofold higher in the PLWH, but neither reached significance. In a model pooling all participants, there were significant differences in the relationship of nitrotyrosine with crPWV and crASI by HIV status.Conclusion: PLWH in sub-Saharan Africa had significantly greater oxidative stress and endothelial activation compared to HIV-negative individuals. These factors may contribute to increased arterial stiffness and higher CVD prevalence in this population.

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HIV is associated with endothelial activation despite ART, in a sub-Saharan African setting

Neurology Neuroimmunology & Neuroinflammation ◽

10.1212/nxi.0000000000000531 ◽

2018 ◽

Vol 6 (2) ◽

pp. e531 ◽

Cited By ~ 11

Author(s):

Joseph Kamtchum-Tatuene ◽

Henry Mwandumba ◽

Zaid Al-Bayati ◽

Janet Flatley ◽

Michael Griffiths ◽

...

Keyword(s):

Hiv Infection ◽

Endothelial Activation ◽

Sub Saharan Africa ◽

Intercellular Adhesion Molecule ◽

Hiv Positive ◽

Plasminogen Activator Inhibitor 1 ◽

Multivariable Logistic Regression Model ◽

Cross Sectional ◽

Sub Saharan ◽

Pai 1

ObjectiveTo study the relationship between endothelial dysfunction, HIV infection, and stroke in Malawians.MethodsUsing a cross-sectional design, we measured plasma levels of intercellular adhesion molecule-1 (ICAM-1), plasminogen activator inhibitor-1 (PAI-1), vascular endothelial growth factor (VEGF), and soluble thrombomodulin (sTM) in stroke patients and controls, stratified by HIV status. These biomarkers were measured using ELISA. After dichotomization, each biomarker was used as the dependent variable in a multivariable logistic regression model. Primary independent variables included HIV and stroke status. Adjustment variables were age, sex, hypertension, diabetes mellitus, tobacco and alcohol consumption, personal/family history of stroke, antiretroviral therapy status, and hypercholesterolemia.ResultsSixty-one stroke cases (19 HIV+) and 168 controls (32 HIV+) were enrolled. The median age was 55 years (38.5–65.0) for controls and 52 years (38.0–73.0) for cases (p = 0.38). The median CD4+ T-cell count was 260.1 cells/mm3 (156.3–363.9) and 452 cells/mm3 (378.1–527.4) in HIV-infected cases and controls, respectively. HIV infection was independently associated with high levels of ICAM-1 (OR = 3.6, 95% CI: 1.3–10.6, p = 0.018) in controls but not in stroke cases even after excluding patients with a viral load >1,000 RNA copies/mL (OR = 4.1, 95% CI: 1.3–13.1, p = 0.017). There was no association between the clinical profiles of HIV-positive controls or HIV-positive stroke and high levels of PAI-1, VEGF, and sTM.ConclusionsHIV infection is associated with endothelial activation despite antiretroviral treatment. Our findings underscore the need for larger clinical cohorts to better understand the contribution of this perturbation of the endothelial function to the increasing burden of cardiovascular diseases in sub-Saharan Africa.

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HIV-Related Arterial Stiffness in Malawian Adults Is Associated With the Proportion of PD-1–Expressing CD8+ T Cells and Reverses With Antiretroviral Therapy

The Journal of Infectious Diseases ◽

10.1093/infdis/jiz015 ◽

2019 ◽

Vol 219 (12) ◽

pp. 1948-1958 ◽

Cited By ~ 1

Author(s):

Christine Kelly ◽

Henry C Mwandumba ◽

Robert S Heyderman ◽

Kondwani Jambo ◽

Raphael Kamng’ona ◽

...

Keyword(s):

T Cells ◽

T Cell ◽

Antiretroviral Therapy ◽

Arterial Stiffness ◽

Cell Count ◽

Cd8 T Cells ◽

Sub Saharan Africa ◽

Cd4 T Cell ◽

Sub Saharan ◽

Cd4 T Cell Count

Abstract Background The contribution of immune activation to arterial stiffness and its reversibility in human immunodeficiency virus (HIV)–infected adults in sub-Saharan Africa is unknown. Methods HIV-uninfected and HIV-infected Malawian adults initiating antiretroviral therapy (ART) with a CD4+ T-cell count of <100 cells/μL were enrolled and followed for 44 weeks; enrollment of infected adults occurred 2 weeks after ART initiation. We evaluated the relationship between carotid femoral pulse wave velocity (cfPWV) and T-cell activation (defined as HLA-DR+CD38+ T cells), exhaustion (define as PD-1+ T cells), and senescence (defined as CD57+ T cells) and monocyte subsets, using normal regression. Results In 279 HIV-infected and 110 HIV-uninfected adults, 142 (37%) had hypertension. HIV was independently associated with a 12% higher cfPWV (P = .02) at baseline and a 14% higher cfPWV at week 10 (P = .02), but the increases resolved by week 22. CD4+ and CD8+ T-cell exhaustion were independently associated with a higher cfPWV at baseline (P = .02). At 44 weeks, arterial stiffness improved more in those with greater decreases in the percentage of CD8+ T cells and the percentage of PD-1+CD8+ T cells (P = .01 and P = .03, respectively). When considering HIV-infected participants alone, the adjusted arterial stiffness at week 44 tended to be lower in those with higher baseline percentage of PD-1+CD8+ T cells (P = .054). Conclusions PD-1+CD8+ T-cells are associated with HIV-related arterial stiffness, which remains elevated during the first 3 months of ART. Resources to prevent cardiovascular disease in sub-Saharan Africa should focus on blood pressure reduction and individuals with a low CD4+ T-cell count during early ART.

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How do HIV-negative individuals in sub-Saharan Africa change their sexual risk behaviour upon learning their serostatus? A systematic review

Sexually Transmitted Infections ◽

10.1136/sextrans-2015-052354 ◽

2016 ◽

Vol 92 (8) ◽

pp. 571-578 ◽

Cited By ~ 9

Author(s):

Sanjeev Ramachandran ◽

Sharmistha Mishra ◽

Natalie Condie ◽

Michael Pickles

Keyword(s):

Systematic Review ◽

Sexual Risk ◽

Risk Behaviour ◽

Sub Saharan Africa ◽

Sexual Risk Behaviour ◽

Sub Saharan ◽

Hiv Negative

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Mechanistic understanding of iron toxicity tolerance in contrasting rice varieties from Africa: 2. Root oxidation ability and oxidative stress control

Functional Plant Biology ◽

10.1071/fp19054 ◽

2020 ◽

Vol 47 (2) ◽

pp. 145

Author(s):

Dorothy A. Onyango ◽

Fredrickson Entila ◽

James Egdane ◽

Myrish Pacleb ◽

Meggy Lou Katimbang ◽

...

Keyword(s):

Oxidative Stress ◽

Sub Saharan Africa ◽

Rice Varieties ◽

Excess Iron ◽

Improvement Programs ◽

Sub Saharan ◽

Breeding Efficiency ◽

Biochemical Analyses ◽

Fe Toxicity ◽

And Control

To enhance breeding efficiency for iron (Fe) toxicity tolerance and boost lowland rice production in sub-Saharan Africa, we have characterised the morphological, physiological and biochemical responses of contrasting rice varieties to excess iron. Here, we report the capacity of four varieties (CK801 and Suakoko8 (tolerant), Supa and IR64 (sensitive)) to oxidise iron in the rhizosphere and control iron-induced oxidative stress. The experiments were conducted in hydroponic conditions using modified Magnavaca nutrient solution and 300 ppm of ferrous iron (Fe2+) supplied in the form of FeSO4. Severe oxidative stress was observed in sensitive varieties as revealed by their high levels of lipid peroxidation. Histochemical and biochemical analyses showed that tolerant varieties exhibited a better development of the aerenchyma and greater oxygen release than the sensitive varieties in response to excess Fe. Both suberin and lignin deposits were observed in the root, stem and leaf tissues but with varying intensities depending on the variety. Under iron toxic conditions, tolerant varieties displayed increased superoxide dismutase (SOD), glutathione reductase (GR), peroxidase (POX) and ascorbate peroxidase (APX) activities in both the roots and shoots, whereas sensitive varieties showed increased APX and catalase (CAT) activities in the roots. This study had revealed also that Suakoko8 mainly uses root oxidation to exclude Fe2+ from its rhizosphere, and CK801 possesses a strong reactive oxygen species scavenging system, in addition to root oxidation ability. Key traits associated with these tolerance mechanisms such as a well-developed aerenchyma, radial oxygen loss restricted to the root cap as well as strong activation of antioxidative enzymes (SOD, GR, POX and APX) could be useful selection criteria in rice varietal improvement programs for enhanced Fe toxicity tolerance.

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HIV infections in sub-Saharan Africa not explained by sexual or vertical transmission

International Journal of STD & AIDS ◽

10.1258/095646202760326390 ◽

2002 ◽

Vol 13 (10) ◽

pp. 657-666 ◽

Cited By ~ 61

Author(s):

David Gisselquist ◽

Richard Rothenberg ◽

John Potterat ◽

Ernest Drucker

Keyword(s):

Hiv Transmission ◽

Sexual Transmission ◽

Hiv Infections ◽

Developed Countries ◽

Sub Saharan Africa ◽

African Women ◽

Heterosexual Transmission ◽

Direction Of Causation ◽

Sub Saharan ◽

Hiv Negative

An expanding body of evidence challenges the conventional hypothesis that sexual transmission is responsible for more than 90% of adult HIV infections in Africa. Differences in epidemic trajectories across Africa do not correspond to differences in sexual behaviour. Studies among African couples find low rates of heterosexual transmission, as in developed countries. Many studies report HIV infections in African adults with no sexual exposure to HIV and in children with HIV-negative mothers. Unexplained high rates of HIV incidence have been observed in African women during antenatal and postpartum periods. Many studies show 20%–40% of HIV infections in African adults associated with injections (though direction of causation is unknown). These and other findings that challenge the conventional hypothesis point to the possibility that HIV transmission through unsafe medical care may be an important factor in Africa's HIV epidemic. More research is warranted to clarify risks for HIV transmission through health care.

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Management of TB/HIV co-infection: the state of the evidence

Ghana Medical Journal ◽

10.4314/gmj.v54i3.10 ◽

2020 ◽

Vol 54 (3) ◽

pp. 186-196

Author(s):

Kwasi Torpey ◽

Adwoa Agyei-Nkansah ◽

Lily Ogyiri ◽

Audrey Forson ◽

Margaret Lartey ◽

...

Keyword(s):

National Level ◽

Hiv Treatment ◽

The State ◽

Sub Saharan Africa ◽

People Living With Hiv ◽

Increased Risk ◽

Mdr Tb ◽

Sub Saharan ◽

Living With Hiv ◽

Hiv Negative

Tuberculosis (TB) and HIV are strongly linked. There is a 19 times increased risk of developing active TB in people living with HIV than in HIV-negative people with Sub-Saharan Africa being the hardest hit region. According to the WHO, 1.3 million people died from TB, and an additional 300,000 TB-related deaths among people living with HIV. Although some progress has been made in reducing TB-related deaths among people living with HIV due to the evolution of diagnostics, treatment and antiretroviral HIV treatment, multi drug resistant TB is becoming a source of worry. Though significant progress has been made at the national level, understanding the state of the evidence and the challenges will better inform the national response of the opportunities for improved patient outcomes.Keywords: Tuberculosis, management, HIV, MDR TB, GhanaFunding: None

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The experiences of HIV-positive and HIV-negative children after receiving disclosure of their own and their parents’ illnesses, respectively

10.7287/peerj.preprints.1328 ◽

2015 ◽

Cited By ~ 1

Author(s):

Grace Gachanja

Keyword(s):

Sub Saharan Africa ◽

Hiv Positive ◽

Hiv Positive Mothers ◽

Sub Saharan ◽

Hiv Negative

The aim of this research brief is to describe a study that sought to understand the post-disclosure experiences of HIV-positive and negative children after they received disclosure of their own and their parents’ illnesses, respectively. This is the first study from Sub-Saharan Africa (SSA) that describes the post-disclosure experiences of HIV-positive and negative children in one study. Prior studies in SSA have mostly centered on the post-disclosure experiences of HIV-positive children after receiving disclosure of their own illnesses, or HIV-positive mothers’ descriptions of the effect of maternal disclosure on their HIV-negative children.

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Prevalence of HIV Infection among Adolescents and Young People at a Tertiary Health Facility in Ekiti State, Southwest, Nigeria

International Journal of Pathogen Research ◽

10.9734/ijpr/2019/v3i330093 ◽

2019 ◽

pp. 1-5

Author(s):

G. O. Daramola ◽

O. O. Oni ◽

H. A. Edogun ◽

A. O. Ojerinde ◽

O. D. Ajayi ◽

...

Keyword(s):

Young People ◽

Health Facility ◽

Significant Proportion ◽

Young Person ◽

The State ◽

Sub Saharan Africa ◽

University Teaching ◽

People Living With Hiv ◽

Southwest Nigeria ◽

Sub Saharan

Background: Nine out of every 10 of the world’s 1.8 billion adolescents and young people (AYP) live in developing nations, Nigeria inclusive. In Nigeria as in the rest of sub-Saharan Africa, 1 out of every 3 persons is an adolescent or a young person. As at 2016, there were about 240, 000 AY) aged 10-19 years in Nigeria, which roughly makes 7% of the total number of people living with HIV (PLWH) in Nigeria. According to 2017 national survey, about 70% of the country’s AYP lack knowledge of how HIV is transmitted or how it can be prevented. Since AYP, aged 10-19 years, constitute a significant proportion of the nation’s burgeoning population, it is very important and critical to fully understand the dynamics of the HIV epidemic among AYP. This study aimed at determining the prevalence of HIV among AYP at a tertiary health facility in Ekiti State, Southwest Nigeria and comparing it with national and regional prevalence among same group. Methodology: The study was a retrospective study of AYP, aged 13-20 years at Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Southwest Nigeria. Convenience and consecutive sampling method was used in retrieving subjects’ data. One hundred subjects whose ages were between 13 and 20 years were consecutively sampled over a period of six months, July to December, 2018. Results: Out of the one hundred subjects retrospectively sampled, 46 (46%) were males, while 54 (54%) were females. Four (4%) of the subjects were 13 years of age, while 6(6%), 5(5%), 8(8%), 27(27%), 17(17%), 12(12%) and 21(21%) respectively were aged 14, 15, 16, 17, 18, 19 and 20 years. Three (3%) of the subjects were positive to HIV, 1 (%) was male, while 2 (20%) were female, thus giving a sero-prevalence rate of 3%. Disaggregation of the positive subjects reveals that 33.3% were male, while 66.7% were females. Conclusion: Though the general prevalence of HIV in Ekiti State ranks among the lowest in Nigeria, group-specific interventions targeting the AYP should be put in place in the State to address the disproportionately high prevalence among the AYP in the State.

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