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Table 1 Published studies on surrogate CVD outcomes in PLWH in sub-Saharan Africa

From: The association between HIV and atherosclerotic cardiovascular disease in sub-Saharan Africa: a systematic review

Study
(location, dates)
Study Design N = Age (years)a ART-status Findings
Fourie et al. [93]
(SA, 2005)
Case-control PLWH: 300
HIV-: 300
44 ± 8
44 ± 8
100% ART-naïve • Untreated HIV associated with higher biomarkers of endothelial injury
Lazar et al. [92]
(Rwanda, 2005)
Prospective cohort PLWH: 276
HIV-: 67
35 ± 7
41 ± 10
59% ART-naïve
41% on ART
• HIV not associated with increased arterial wave reflection
Botha et al. [132]
(SA, 2005-10)
Prospective cohort PLWH: 137 no ART: 47.6 ± 1.9
on ART: 47.8 ± 1.6
52% ART-naïve
48% on ART
• ART exposure associated with higher pulse pressure
Fourie et al. [78]
(SA, 2005-10)
Prospective cohort PLWH: 144
HIV-: 165
no ART: 48 ± 1
on ART: 49 ± 1
50 ± 1
54% ART-naïve
46% on ART
• >5y HIV infection associated with increased biomarkers of endothelial activation
Ngatchou et al. [94]
(Cameroon, 2009-10)
Cross-sectional PLWH: 108
HIV-: 96
39 ± 11
41 ± 12
100% ART-naïve • HIV associated with aortic stiffness as assessed by radial tonometry
Ngatchou et al. [133]
(Cameroon, 2009-10)
Cross-sectional PLWH: 238 no ART: 39 ± 11
on ART: 41 ± 12
45% ART-naïve
55% on ART
• ART exposure associated with increased pulse pressure and augmentation index among ART-experienced patients compared to untreated PLWH
Ssinabulya et al. [95]
(Uganda, 2012)
Cross-sectional PLWH: 245 37 (31-37) 59% ART-naïve
41% on ART
• HIV associated with 18% risk of pre-clinical carotid atherosclerosis on ultrasound imaging
Awotedu et al. [96]
(SA, 2012-13)
Cross-sectional PLWH: 106
HIV-: 63
no ART: 36 ± 11
on ART: 40 ± 10
36 ± 11
51% ART-naïve
49% on ART
• HIV associated with increased aortic pulse wave velocity
• Highest increase among ART-experienced
Schoffelen et al. [99]
(SA, 2013)
Cross-sectional PLWH: 904 41 (35-48) 13% ART-naïve
87% on ART
• cIMT associated with traditional CVD risk factors, not HIV-specific factors
Siedner et al. [97]
(Uganda, 2013-14)
Cross-sectional PLWH: 105
HIV-: 100
49 (45-51)
50 (46-54)
100% on ART • HIV associated with twice the risk of arterial stiffness as assessed by calculating ankle-brachial index
Feinstein et al. [98]
(Uganda, not stated)
Cross-sectional PLWH: 105
HIV-: 100
49 ± 6
52 ± 9
100% on ART • HIV not associated with carotid intima media thickness
Gleason et al. [81]
(Ethiopia, not stated)
Cross-sectional PLWH: 281
HIV-: 36
no ART: 38 (32-45)
EFV: 38 (32-45)
LPV/r: 39 (35-44)
NVP: 37 (32-42)
39 (29-45)
18% ART-naïve
82% on ART
• Use of EFV & LPV/r, nut not NVP, is associated with elevated pulse wave velocity, normalized cIMT, and abnormal FMD
Mosepele et al. [91]
(Botswana, not stated)
Cross-sectional PLWH: 208 39 (5) 25% ART-naïve
75% on ART
• Atherosclerotic CVD risk score and cIMT measurement similarly identify high CVD risk
  1. amean ± SD or median (IQR)
  2. PLWH people living with HIV, SA South Africa, ART antiretroviral therapy, EFV efavirenz, LPV/r lopinavir/r, NVP nevirapine, cIMT carotid intima-media thickness, FMD flow-mediated dilation
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