Williams Cassidy, Kamau Festus M, Everson Frans, Kgokane Boipelo, De Boever Patrick, Goswami Nandu, Webster Ingrid, Strijdom Hans
Centre for Cardio-Metabolic Research in Africa, Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa.
Department of Biology, University of Antwerp, 2610 Wilrijk, Belgium.
J Clin Med. 2021 Sep 12;10(18):4112. doi: 10.3390/jcm10184112.
Cardiovascular-related complications are on the rise in people with HIV/AIDS (PWH); however, the relationship among HIV and antiretroviral therapy (ART)-related parameters, cardiovascular risk, and cardiac electrical activity in PWH remain poorly studied, especially in sub-Saharan African populations. We investigated whether HIV and ART are associated with cardiometabolic and cardiac electrical activity in PWH from Worcester in the Western Cape Province, South Africa. This was a cross-sectional study with HIV-negative (HIV-, = 24) and HIV-positive on ART (HIV+/ART+, = 63) participants. We obtained demographic, lifestyle, and medical history data and performed anthropometric, clinical assessments, and blood/urine biochemistry. We performed multiple stepwise linear regression analyses to determine independent associations among HIV, ART, cardiometabolic, and electrocardiographic (ECG) variables. HIV+/ART+ independently associated with a lower body mass index ( = 0.004), elevated gamma-glutamyl transferase levels (β: 0.333 (0.130-0.573); = 0.002), and elevated alanine aminotransferase levels (β: 0.427 (0.224-0.629); < 0.001) compared to HIV-. Use of second-line ART was positively associated with high-sensitivity C-reactive protein ( = 0.002). Although ECG parameters did not differ between HIV- and HIV+/ART+, viral load positively associated with -wave duration (0.306 (0.018-0.594); = 0.038), and longer HIV duration (≥5 years) with ST-interval (0.270 (0.003-0.537); = 0.047) after adjusting for confounding factors. Our findings suggest that HIV and ART are associated with mixed effects on this population's cardiometabolic profile and cardiac electrical activity, underpinning the importance of cardiovascular risk monitoring in PWH.
在感染艾滋病毒/艾滋病的人群（PWH）中，心血管相关并发症的发生率正在上升；然而，艾滋病毒与抗逆转录病毒疗法（ART）相关参数、心血管风险以及PWH的心脏电活动之间的关系仍研究不足，尤其是在撒哈拉以南非洲人群中。我们调查了在南非西开普省伍斯特市的PWH中，艾滋病毒和ART是否与心脏代谢及心脏电活动相关。这是一项横断面研究，参与者包括艾滋病毒阴性（HIV-，n = 24）和接受ART的艾滋病毒阳性者（HIV+/ART+，n = 63）。我们获取了人口统计学、生活方式和病史数据，并进行了人体测量、临床评估以及血液/尿液生化检测。我们进行了多重逐步线性回归分析，以确定艾滋病毒、ART、心脏代谢和心电图（ECG）变量之间的独立关联。与HIV-相比，HIV+/ART+与较低的体重指数独立相关（P = 0.004），γ-谷氨酰转移酶水平升高（β：0.333（0.130 - 0.573）；P = 0.002），以及丙氨酸氨基转移酶水平升高（β：0.427（0.224 - 0.629）；P < 0.001）。使用二线ART与高敏C反应蛋白呈正相关（P = 0.002）。尽管HIV-和HIV+/ART+之间的ECG参数没有差异，但在调整混杂因素后，病毒载量与Q波持续时间呈正相关（0.306（0.018 - 0.594）；P = 0.038），艾滋病毒感染持续时间较长（≥5年）与ST段呈正相关（0.270（0.003 - 0.537）；P = 0.047）。我们的研究结果表明，艾滋病毒和ART对该人群的心脏代谢特征和心脏电活动具有混合效应，这突出了对PWH进行心血管风险监测的重要性。
