Cardiovascular Risk in HIV/AIDS and Lipodystrophy Syndrome Patients

Authors

  • Valdelias Xavier Pereira
  • Fernando Rocha Oliveira
  • Luiz Carlos de Abreu Faculdade de Medicina do ABC. Departamento de Saúde da Coletividade. Disciplina de Metodologia Científica.
  • Mariliza Henrique da Silva
  • Celso Ferreira Filho
  • Fernando Adami
  • Francisco Winter do Santos Figueiredo
  • Laércio da Silva Paiva
  • Renata Macedo Martins Pimentel
  • Vitor Engracia Valenti
  • Adriano Luis Roque
  • Rubens Wajnsztejn
  • Tatiana Dias de Carvalho
  • Karina Viviani de Oliveira Pessoa
  • Celso Ferreira

DOI:

https://doi.org/10.3823/1813

Keywords:

HIV, AIDS, cardiovascular disease, highly active antiretroviral therapy

Abstract

Background:The treatment of people living with AIDS, known a highly active antiretroviral therapy (HAART), has increased considerably, and the disease has therefore acquired chronic features. Several changes have been observed, especially in cardiovascular disease risk. Objective: To assess cardiovascular risk in HIV/AIDS patients treated with HAART and compare this with Lipodystrophy Syndrome (LS) carriers. Methods: This is a descriptive cross-sectional study. 192 patients were recruited from a lipodystrophy outpatient centre, using Framingham risk scores. Results: After criteria inclusion/exclusion, the final sample consisted of 81 patients divided into two groups (HIV/AIDS - without lipodystrophy and HIV/LS - with lipodystrophy). The mean age of HIV/AIDS was 46.5 years, and of the HIV/LS patients was 52 years. In accordance with Framingham scores the cardiovascular risk in HIV/AIDS was 46.59% and 14.29% in HIV/LS. Conclusion: The risk of cardiovascular disease over 10 years is significantly higher in patients with lipodystrophy syndrome.

References

Referências

Palella FJ, Delaney KM, Moorman AC et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. N Engl J Med. 1998; 338: 853-60.

Suit, D, Chaves AM. Ser feminina: uma permissão para a soropositividade?. Rev. bras. crescimento desenvolv. hum. 2005; 15: 82-90.

Kawagoe J. et al. As dificuldades de adaptação do convívio social de pacientes portadores de HIV/AIDS. Rev. bras. crescimento desenvolv. hum. 2012; 22: 93-97.

Dube M, Sattler F. Metabolic complications of antiretroviral therapies. AIDS Clin Care. 1998; 10: 41-4.

Sweet DE. Metabolic complications of antiretroviral therapy. Top HIV Med. 2005; 13 (2): 70-74.

Currier JS, Havlir DV. Complications of HIV disease and antiretroviral therapy. Top HIV Med. 2005; 13 (1): 16-23.

Stein J. Dyslipidemia in the era of HIV protease inhibitors. Prog Cardiovasc Dis. 2003; 45: 293-304.

Barbaro G. Metabolic and cardiovascular complications of highly active antiretroviral therapy for HIV infection. Curr HIV Res. 2006; 4: 79-85.

Barbaro G. Highly active antiretroviral therapy-associated metabolic syndrome: pathogenesis and cardiovascular risk. Am J Therapeutics. 2006; 13: 248-60.

Grinspoon S, Carr A. Cardiovascular risk and body fat abnormalities in HIV-infected adults. N Engl J Med. 2005; 352: 48-62.

Carr A, Samaras K, Burton S et al. A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance in patients receiving HIV protease inhibitors. AIDS. 1998; 12: 51-58.

Hajjar LA, Calderaro D, Yu PC, Giuliano I et al. Cardiovascular manifestations in patients with the human immunodeficiency virus. Arq Bras Cardiol. 2005; 85 (5): 365-77.

D'Arminio MA, Sabin CA, Philllips A, et al. The changing incidence of AIDS events in patients receiving highly active antiretroviral therapy. Arch Intern Med. 2005;165(4):416-23.

Friis-Moller N, Weber R, Reiss P et al. For the D.A.D Study Group. Cardiovascular disease risk factors in HIV patients - associations with antiretroviral therapy: results from the DAD Study. AIDS. 2003; 17: 1179-93.

Holmberg SD, Moorman AC, Willianson JM et. al. and the HIV Outpatient Study (HOPS) Investigators. Protease inhibitors and cardiovascular outcomes in patients with HIV-1. Lancet. 2002; 360: 1747-8.

Mary-Krause M, Cotte L, Simon A, Partisani M, Costagliola D and the Clinical Epidemiology Group from the French Hospital Database. Increased risk for myocardial infarction with duration of protease inhibitor therapy in HIV-infected men. AIDS. 2003; 17: 2479-86.

Currier J, Taylor A, Boyd F et al. Coronary heart disease in HIV-infected individuals. J Acquir Immune Defic Syndr. 2003; 33: 506-12.

Wilson PW, Meigs JB, Sullivan L, et. al. Prediction of incident diabetes mellitus in middle-aged adults: the Framingham Offspring Study. Arch Intern Med. 2007;167:1068–74

Bruno R, Gazzaruso C, Sacchi P, et al. High prevalence of metabolic syndrome among HIV-infected patients: link with the cardiovascular risk. J Acquir Immune Defic Syndr. 2002; 31: 363-5.

Estrada V, Martinez-Larrad T, Gonzalez-Sanchez JL et al. Lipodystrophy and metabolic syndrome in HIV-infected patients treated with antiretroviral therapy. Metabolism. 2006; 55 (7): 940-5.

Dawber TR, Meadors GF, Moore FE Jr. Epidemiolofical approaches to heart disease: the Framingham Study. Am J Public Health. 1951; 41 (3): 279-81.

Pereira VX, Abreu LC, Valente VE et al. "The Lipodystrophy Syndrome as a Risk Marker for Cardiovascular Disease in Patients with HIV/AIDS Treated with HAART." International Archives of Medicine. 2015; 8: 1-12.

Mehta N, Reilly M. Atherosclerotic cardiovascular disease risk in the HAART-treated HIV-1 population. HIV Clin Trials, 2005; 6: 5-24.

Hajjar LA, Calderaro D, Yu PC, et al. Cardiovascular manifestations in patients infected with the human immunodeficiency virus. Arq Bras Cardiol, 2005; 85: 363-377

, Carr, A.; Cooper, D. A. Adverse effects of antiretroviral therapy. Lancet, 2000; 356: 1423-30.

Diehl LA, Dias JR, Paes AC, Thomazini MC, Garcia LR, Cinagawa E, Wiechmann SL, Carrilho AJ. Prevalence of HIV-associated lipodystrophy in Brazilian outpatients: relation with metabolic syndrome and cardiovascular risk factors. Arq Bras Endocrinol Metabol. 2008; 52: 658-67.

Freitas P. et. al. Impact of Lipodystrophy on the prevalence and components of metabolic syndrome in HIV-infected patients. BMC Infectious Diseases 2011; 11: 246-8.

Bergensen BM, Sandvik L, Brunn JN, Tonstad S. Elevated Framingham risk score in HIV-positive patients on highly active antiretroviral therapy: results from a Norwegian study of 721 subjects. Eur J Clin Microbiol Infect Dis. 2004; 23: 625-30.

Dahlöf, B. "Cardiovascular disease risk factors: epidemiology and risk assessment." Am J Cardiol. 2010; 105: 3-9.

Kannel, W. " Some lessons in cardiovascular epidemiology from Framingham." Am J Cardiol. 1976; 37: 269 –282.

Wilson PW, K. W., Silbershatz H, D’Agostino RB. "Clustering of metabolic factors and coronary heart disease." Arch Intern Med. 1999; 159: 1104 –1109.

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Published

2015-10-06

Issue

Vol. 8 (2015)

Section

Cardiovascular Biology

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