Table 1 Published studies on CVD outcomes among PLHIV in Asia-Pacific counties with the greatest impact of CVD attributable to HIV status

Karim et al. 2017 [19]

(Indonesia, 2013–2014)

Prospective cohort

1-year follow-up:

PLHIV: 67

Median:

31 years (range 19–48 years)

1. Carotid Intima-Media thickness (cIMT)

2. Diameter of carotid artery

1. Right cIMT among PLHIV (0.70 mm) was higher than uninfected (0.58 mm) after 12 months of ART initiation, p < 0.05.

2. Left cIMT among PLHIV (0.65 mm) was higher than that of uninfected (0.58 mm) after 12 months of ART initiation, p < 0.05.

3. No difference in the diameter of the right and left carotid artery after 12 months of ART initiation.

4. Traditional risk factors associated with cIMT and carotid artery diameter after 6 months of ART initiation, p < 0.05.

5. HIV-related factors associated with carotid artery diameter after 3 months of ART initiation, p < 0.05.

Subsai et al. 2006 [20]

(Thailand, 2002–2004)

*Poor quality

Retrospective

Cohort

2 years follow-up:

PLHIV: 506

Mean: 36.8 ± 7.9

Hemorrhagic stroke or ischemic stroke

The incidence rate of hemorrhagic stroke:1.17/100 pys The incidence rate of ischemic stroke: 2.35/100 pys

The incidence rate of stroke in the HAART era is higher than in the pre-HAART era.

Sitticharoenchai et al. 2019 [21]

(Thailand, 2010–2015)

*Good quality

Retrospective

cohort

5 years follow-up: 2010 to 2015

PLHIV: 1,813

Median: 44

(range 38–50)

1. Coronary artery diseases

2. Ischemic stroke

1. Incidence rate of CVD: 3.75/1000 pys

2. Previous ischemic stroke and family history of CVD associated with CVD event, Adj OR 34.69 (95%CI 5.15-233.45) and Adj OR 6.89 (95%CI 2.57–18.48).

3. Interaction effect between diabetes mellitus and dyslipidemia on CVD: Adj OR 17.2 (95%CI 7.8–38.3)

4. Interaction effect between family history of CVD, diabetes mellitus and dyslipidemia on CVD: Adj OR 22.2 (95%CI 4.1-118.5).

5. High proportion of CVD among young HIV adult age < 55 years, 52.95%

Aurpibul et al. 2019 [22]

(Thailand, 2015)

*Good quality

Cross-sectional

PLHIV: 107

Non-HIV: 48

PLHIV

Mean: 58.7 ± 6.5

Non-HIV

Mean:59.7 ± 6.5

1. Subclinical atherosclerosis measured by Cardio-ankle vascular index (CAVI)

2. Peripheral artery disease (PAD) measured by Ankle- brachial index (ABI)

1. Prevalence of subclinical atherosclerosis (23% and 29%) and prevalence of PAD (6% and 8%) between PLHIV and NonHIV

2. DM associated with CAVI among PLHIV, Adj OR 1.54 (95%CI 1.01–2.35).

Putcharoen et al. 2019 [23]

(Thailand, 2016–2017)

*Good quality

Cross-sectional

PLHIV: 60

Non-HIV: 30

PLHIV

Median: 54.9 (range 52–60)

Non-HIV

Median: 53 (range 50–60)

Carotid Intima-Media thickness (cIMT)

1. No difference in median overall cIMT between PLHIV (0.665 mm) and NonHIV (0.649 mm).

2. Of PLHIV, 10% was observed plague.

3. Male and hypertension associated with thicker cIMT among PLHIV, β = 0.041 (95%CI 0.001–0.081) and β = 0.047 (95%CI 0.003–0.092).

Siwamogsatham et al. 2019 [24]

(Thailand, 2016–2017)

*Good quality

Cross-sectional

PLHIV: 316

Median age: 54.4 (IQR 51.7–59.4)

Carotid Intima-Media thickness (cIMT)

1. Subclinical CVD 28.2%

2. Age positively associated with subclinical atherosclerosis, Adj OR 1.06 (95%CI 1.003–1.12).

3. CD4 count (< 200 cells/mm³) associated with subclinical atherosclerosis, Adj OR 1.80 (95%CI 1.02–3.18).

Utama et al. 2019 [25]

(Indonesia, 2017)

*Good quality

Cross-sectional

PLHIV: 50

Mean: 30.60 ± 5.58

Carotid Intima-Media thickness (cIMT)

1. Older age increases the diameter of cIMT at β 0.012 (95%CI 0.002–0.022).

2. CD4/CD8 ratio increases the diameter of cIMT at β= -0.791 (95%CI -0.99 to -0.592).

Rajasuriar et al. 2015 [26]

(Malaysia, NA)

*Good quality

Cross-sectional

PLHIV: 84

Median:

41 (IQR 36–46)

Carotid Intima-Media thickness (cIMT)

Prevalence of subclinical atherosclerosis: 27.4%

Aurpibul et al. 2019 [27]

(Thailand, 2015)

*Good quality

Cross-sectional

PLHIV: 362

Non-HIV⁻: 362

PLHIV: Mean 57.8 ± 5.6

Non-HIV: Mean 58.1 ± 5.7

Peripheral artery disease (PAD) measured by ABI

1. Prevalence of PAD among PLHIV (5%) and nonHIV (7%) did not differ.

2. Prevalence of abnormal ABI among PLHIV (20%) were lower than that of uninfected(27%), p0.03.

3. Female sex and underweight associated with abnormal ABI among PLHIV, Adj OR 2.09 (95%CI 1.20–3.67) and Adj OR 1.73 (95%CI 1.02–2.95).

Nakaranurack, Manosuthi. 2018 [28]

(Thailand, 2011)

*Good quality

Cross-sectional

PLHIV: 874

45.5 ± 8.3

CVD

Prevalence of CVD among PLHIV: 1.3%

Lee et al. 2012 [29]

(Thailand, 2009–2010)

*Good quality

Case-Control

PLHIV with stroke: 37

PLHIV without stroke: 74

PLHIV with stroke: 50.5 ± 11.1

PLHIV without stroke: 50.4 ± 13.4

Stroke (cerebral infarction and intracerebral hemorrhage)

Tuberculous meningitis (Adj OR 11.9; 95%CI 1.2-117.2) and smoking (Adj OR 6.9; 95%CI 2.3–21.2) are associated with stroke among PLHIV.