Prediction of cardiovascular disease risk using framingham and data on adverse effect of antiretroviral drugs risk equation in relation to lipodystrophy in HIV patients on highly active antiretroviral therapy

In the last 15 years, highly active antiretroviral therapy (HAART) has determined a dramatic reduction of both morbidity and mortality in human immunodeficiency virus (HIV)-infected subjects, transforming this infection in a chronic and manageable disease. Patients surviving with HIV in the developed world, in larger number men, are becoming aged. As it would be expected for a population of comparable age, many HIV-infected individuals report a family history of cardiovascular disease, a small proportion have already experienced a cardiovascular event and an increasing proportion has diabetes mellitus. Smoking rate is very high while an increasing proportion of HIV-infected individuals have dyslipidaemia. Studies suggest that these traditional risk factors could play an important role in the development of cardiovascular disease in these patients as they do in the general population. Thus, whilst the predicted 10-year cardiovascular disease risk remains relatively low at present, it will likely increase in relation to the progressive aging of this patient population. Thus, the long-term follow-up of HIV infected patients has to include co-morbidity management such as cardiovascular disease prevention and treatment. Two intriguing aspects related to the cardiovascular risk in patients with HIV infection are the matter of current investigation: 1) while these subjects share many cardiovascular risk factors with the general population, HIV infection itself increases cardiovascular risk; 2) some HAART regimens too influence atherosclerotic profile, partly due to lipid changes. Although the mechanisms involved in the development of cardiovascular complications in HIV-infected patients remain to be fully elucidated, treatment guidelines recommending interventions to prevent cardiovascular disease in these individuals are already available; however, their application is still limited.

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Beneficial and Detrimental Effects of Antiretroviral Therapy on HIV-Associated Immunosenescence

Chemotherapy ◽

10.1159/000487534 ◽

2018 ◽

Vol 63 (2) ◽

pp. 64-75 ◽

Cited By ~ 5

Author(s):

Ornella Franzese ◽

Maria Luisa Barbaccia ◽

Enzo Bonmassar ◽

Grazia Graziani

Keyword(s):

Antiretroviral Therapy ◽

Hiv Infection ◽

Highly Active Antiretroviral Therapy ◽

Immunological Response ◽

Antiretroviral Drugs ◽

Hiv Patients ◽

Progressive Decline ◽

Highly Active ◽

Anti Hiv Agents

Since the introduction of highly active antiretroviral therapy more than 2 decades ago, HIV-related deaths have dramatically decreased and HIV infection has become a chronic disease. Due to the inability of antiretroviral drugs to eradicate the virus, treatment of HIV infection requires a systemic lifelong therapy. However, even when successfully treated, HIV patients still show increased incidence of age-associated co-morbidities compared with uninfected individuals. Virus- induced immunosenescence, a process characterized by a progressive decline of immune system function, contributes to the premature ageing observed in HIV patients. Although antiretroviral therapy has significantly improved both the quality and length of patient lives, the life expectancy of treated patients is still shorter compared with that of uninfected individuals. In particular, while antiretroviral therapy can contrast some features of HIV-associated immunosenescence, several anti-HIV agents may themselves contribute to other aspects of immune ageing. Moreover, older HIV patients tend to have a worse immunological response to the antiviral therapy. In this review we will examine the available evidence on the role of antiretroviral therapy in the control of the main features regulating immunosenescence.

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Change in body mass index (BMI) after highly active antiretroviral therapy among hiv patients in kano, Northwestern Nigeria

Endocrine Abstracts ◽

10.1530/endoabs.48.p10 ◽

2017 ◽

Author(s):

Fakhraddeen Muhammad ◽

Mansur Ramalan ◽

Adenike Enikuomehin

Keyword(s):

Body Mass Index ◽

Antiretroviral Therapy ◽

Body Mass ◽

Highly Active Antiretroviral Therapy ◽

Hiv Patients ◽

Highly Active

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Hematological Profile of HIV-Infected Patients on First-Line Highly Active Antiretroviral Therapy and Its Correlation With CD4 Count

International Journal of Recent Surgical and Medical Sciences ◽

10.1055/s-0041-1730257 ◽

2021 ◽

Author(s):

John Jospeh Diamond Princy ◽

Kshetrimayum Birendra Singh ◽

Ningthoujam Biplab ◽

Ningthoukhongjam Reema ◽

Rajesh Boini ◽

...

Keyword(s):

Platelet Count ◽

Antiretroviral Therapy ◽

Hiv Infection ◽

Highly Active Antiretroviral Therapy ◽

Cd4 Count ◽

Total Leukocyte Count ◽

Hiv Patients ◽

Positive Correlation ◽

Highly Active ◽

The Mean

Abstract Introduction Human immunodeficiency virus (HIV) infection is a state of profound immunodeficiency. Disorders of hematopoietic system are a common but often overlooked complication of HIV infection. This can manifest at any stage of the disease but more commonly in the advanced stage with low CD4 count. Anemia is the most common hematological abnormality in HIV patients and prevalence ranges from 1.3 to 95%. As HIV disease progresses, the prevalence and severity of anemia also increase. Hence, this study was undertaken to assess the hematological parameters of HIV-infected patients on highly active antiretroviral therapy (HAART) at different treatment durations with the hope to improve the HAART outcome in HIV patients and its correlation with CD4 count. Methods This prospective longitudinal study enrolled 134 HIV-infected patients admitted to or attending the OPD in the Department of Medicine or Antiretroviral Therapy (ART) Center (Center of Excellence), Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, from 2018 to 2020. Complete hemogram, CD4 count, and other related-blood investigations were studied. Results The mean age of the study population was 39.9 ± 11.04 years. Of the 134 patients, 75 (56%) were males and 59 (44%) were females. Twelve (9%) patients had a history of injecting drug use (IDU). TLE (tenofovir, lamivudine, efavirenz) regimen was started on 112 (83.6%) patients and the majority of them (69/134 [51.5%]) had a CD4 count of 200 to 499 cells/mm3, which increased significantly 6 months after HAART to 99 to 1,149 cells/mm3, with a mean of 445 ± 217 cells/mm3. There were significant improvements in hemoglobin (Hb) levels, total leukocyte count (TLC), absolute neutrophil count (ANC), and absolute lymphocyte count (ALC) after HAART indicating a positive correlation with CD4 count (p < 0.05). Thrombocytopenia was observed higher after HAART when compared to baseline. There was a positive correlation between platelet count and CD4 count. However, the mean corpuscular volume (MCV) and erythrocyte sedimentation rate (ESR) had a negative correlation with CD4 count. Conclusion The study inferred a strong positive correlation between CD4 and Hb levels, TLC, ANC, ALC, and platelet count after HAART with improvement in these values as CD4 count increases. Specific treatment intervention based on the changes in the immunohematological profile trends can help prevent most of the adverse effects on HIV patients in our community.

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Cardiovascular Disease-Risk Markers in HIV Patients

Journal of AIDS & Clinical Research ◽

10.4172/2155-6113.1000317 ◽

2014 ◽

Vol 05 (07) ◽

Cited By ~ 6

Author(s):

Bela F. Asztalos

Keyword(s):

Cardiovascular Disease ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Risk Markers ◽

Hiv Patients

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Contribution of antiretroviral therapy to cardiovascular disease risk in HIV-infected patients

Future Virology ◽

10.2217/fvl-2016-0047 ◽

2016 ◽

Vol 11 (7) ◽

pp. 509-527 ◽

Cited By ~ 1

Author(s):

Shana Burrowes ◽

Patrick Cahill ◽

Shyamasundaran Kottilil ◽

Shashwatee Bagchi

Keyword(s):

Cardiovascular Disease ◽

Antiretroviral Therapy ◽

Disease Risk ◽

Cardiovascular Disease Risk

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Persistence of Genital Tract T Cell Responses in HIV-Infected Women on Highly Active Antiretroviral Therapy

Journal of Virology ◽

10.1128/jvi.00518-10 ◽

2010 ◽

Vol 84 (20) ◽

pp. 10765-10772 ◽

Cited By ~ 9

Author(s):

Nonhlanhla N. Mkhize ◽

Pamela P. Gumbi ◽

Lenine J. Liebenberg ◽

Yuan Ren ◽

Peter Smith ◽

...

Keyword(s):

T Cell ◽

Antiretroviral Therapy ◽

Highly Active Antiretroviral Therapy ◽

Genital Tract ◽

T Cell Responses ◽

Antiretroviral Drugs ◽

Cd4 T Cell ◽

Cell Responses ◽

Highly Active ◽

Cell Counts

ABSTRACT Initiation of highly active antiretroviral therapy (HAART) for HIV-infected individuals is associated with control of viremia, improved CD4 counts, and declining systemic HIV-specific immune responses. While HAART effectively reduces plasma viremia, it remains unclear how effectively antiretroviral drugs reach mucosal surfaces, such as those of the genital tract. The aim of this study was to determine the effect of HAART on genital tract CD4 T cell reconstitution, HIV shedding, and HIV-specific T cell responses. Cervical cytobrush and blood specimens were obtained from 35 HIV-infected, HAART-naïve women and 27 women on HAART in order to investigate HIV Gag-specific T cell responses by intracellular gamma interferon (IFN-γ) staining. Interleukin 1β (IL-1β), IL-6, and IL-8 concentrations were measured by enzyme-linked immunosorbent assays (ELISA). We show that for HIV-infected women, HAART is associated with significantly improved CD4 T cell counts both in blood and at the cervix. While HAART effectively suppressed both blood and cervical viremia, HIV-specific CD8 T cell responses in blood were lost, while those at the cervix were preserved.

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