Hypertension in Africa Research Team (HART), North-West University, Private Bag X1290, Potchefstroom, South Africa.
South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
BMC Infect Dis. 2020 Jul 3;20(1):473. doi: 10.1186/s12879-020-05173-6.
People living with the Human Immunodeficiency Virus (PLHIV) have an increased susceptibility to develop non-communicable diseases such as cardiovascular disease (CVD). Infection with HIV contributes to the development of CVD independent of traditional risk factors, with endothelial dysfunction being the central physiological mechanism. While HIV-related mortality is declining due to antiretroviral treatment (ART), the number of deaths due to CVD is rising in South Africa - the country with the highest number of PLHIV and the world's largest ART programme. The EndoAfrica study was developed to determine whether HIV infection and ART are associated with cardiovascular risk markers and changes in vascular structure and function over 18 months in adults from different provinces of South Africa. This paper describes the rationale, methodology and baseline cohort profile of the EndoAfrica study conducted in the North West Province, South Africa.
In this case-control study, conducted between August 2017 and June 2018, 382 volunteers of African descent (276 women; 106 men), comprising of 278 HIV infected and 104 HIV free individuals were included. We measured health behaviours, a detailed cardiovascular profile, and performed biomarker analyses. We compared baseline characteristics, blood pressure, vascular function and biochemical markers between those infected and HIV free.
At baseline, the HIV infected participants were older (43 vs 39 years), less were employed (21% vs 40%), less had a tertiary education (7% vs 16%) and their body mass index was lower (26 vs 29 kg/m) than that of the HIV free participants. While the cardiovascular profile, flow-mediated dilation and pulse wave velocity did not differ, glycated haemoglobin was lower (p = 0.017) and total cholesterol, high density lipoprotein cholesterol, triglycerides, gamma-glutamyltransferase and tobacco use were higher (all p < 0.047) in PLHIV.
Despite PLHIV being older, preliminary cross-sectional analysis suggests that PLHIV being treated with ART do not have poorer endothelial or vascular function compared to the HIV free participants. More detailed analyses on the baseline and follow-up data will provide further clarity regarding the cardiovascular profile of South Africans living with HIV.
人类免疫缺陷病毒（HIV）感染者（PLHIV）易患非传染性疾病，如心血管疾病（CVD）。HIV 感染会导致 CVD 的发生，而与传统危险因素无关，其中内皮功能障碍是中心生理机制。尽管由于抗逆转录病毒治疗（ART）的应用，HIV 相关死亡率正在下降，但南非的 CVD 死亡人数却在上升——南非是 HIV 感染者人数最多的国家，也是世界上最大的 ART 项目所在地。EndoAfrica 研究旨在确定 HIV 感染和 ART 是否与心血管风险标志物以及南非不同省份成年人的血管结构和功能在 18 个月内的变化有关。本文介绍了在南非西北省进行的 EndoAfrica 研究的原理、方法和基线队列特征。
在这项病例对照研究中，共纳入 382 名非洲裔志愿者（276 名女性；106 名男性），包括 278 名 HIV 感染者和 104 名 HIV 阴性者。我们测量了健康行为、详细的心血管指标，并进行了生物标志物分析。我们比较了感染者和 HIV 阴性者之间的基线特征、血压、血管功能和生化标志物。
在基线时，HIV 感染者年龄更大（43 岁比 39 岁），就业比例更低（21%比 40%），受教育程度更高（7%比 16%），体重指数更低（26 比 29kg/m）。尽管心血管指标、血流介导的扩张和脉搏波速度没有差异，但糖化血红蛋白水平更低（p=0.017），总胆固醇、高密度脂蛋白胆固醇、甘油三酯、γ-谷氨酰转移酶和吸烟率更高（所有 p<0.047）。
尽管 HIV 感染者年龄更大，但初步横断面分析表明，接受 ART 治疗的 PLHIV 的内皮或血管功能并不比 HIV 阴性者差。对基线和随访数据的更详细分析将进一步阐明南非 HIV 感染者的心血管特征。
