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

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dc.contributor.authorHyle, Emily P
dc.contributor.authorMayosi, Bongani M
dc.contributor.authorMiddelkoop, Keren
dc.contributor.authorMosepele, Mosepele
dc.contributor.authorMartey, Emily B
dc.contributor.authorWalensky, Rochelle P
dc.contributor.authorBekker, Linda‐Gail
dc.contributor.authorTriant, Virginia A
dc.date.accessioned2021-10-08T06:54:52Z
dc.date.available2021-10-08T06:54:52Z
dc.date.issued2017
dc.description.abstractBACKGROUND: Sub-Saharan Africa (SSA) has confronted decades of the HIV epidemic with substantial improvements in access to life-saving antiretroviral therapy (ART). Now, with improved survival, people living with HIV (PLWH) are at increased risk for non-communicable diseases (NCDs), including atherosclerotic cardiovascular disease (CVD). We assessed the existing literature regarding the association of CVD outcomes and HIV in SSA. METHODS: We used the PRISMA guidelines to perform a systematic review of the published literature regarding the association of CVD and HIV in SSA with a focus on CVD surrogate and clinical outcomes in PLWH. RESULTS: From January 2000 until March 2017, 31 articles were published regarding CVD outcomes among PLWH in SSA. Data from surrogate CVD outcomes (n = 13) suggest an increased risk of CVD events among PLWH in SSA. Although acute coronary syndrome is reported infrequently in SSA among PLWH, limited data from five studies suggest extensive thrombus and hypercoagulability as contributing factors. Additional studies suggest an increased risk of stroke among PLWH (n = 13); however, most data are from immunosuppressed ART-naïve PLWH and thus are potentially confounded by the possibility of central nervous system infections. CONCLUSIONS: Given ongoing gaps in our current understanding of CVD and other NCDs in PLWH in SSA, it is imperative to ascertain the burden of CVD outcomes, and to examine strategies for intervention and best practices to enhance the health of this vulnerable population.
dc.identifier.apacitationHyle, E. P., Mayosi, B. M., Middelkoop, K., Mosepele, M., Martey, E. B., Walensky, R. P., ... Triant, V. A. (2017). The association between HIV and atherosclerotic cardiovascular disease in sub-Saharan Africa: a systematic review. <i>BMC Public Health</i>, 17(1), 174 - 177. http://hdl.handle.net/11427/34361en_ZA
dc.identifier.chicagocitationHyle, Emily P, Bongani M Mayosi, Keren Middelkoop, Mosepele Mosepele, Emily B Martey, Rochelle P Walensky, , and Virginia A Triant "The association between HIV and atherosclerotic cardiovascular disease in sub-Saharan Africa: a systematic review." <i>BMC Public Health</i> 17, 1. (2017): 174 - 177. http://hdl.handle.net/11427/34361en_ZA
dc.identifier.citationHyle, E.P., Mayosi, B.M., Middelkoop, K., Mosepele, M., Martey, E.B., Walensky, R.P., & Triant, V.A. et al. 2017. The association between HIV and atherosclerotic cardiovascular disease in sub-Saharan Africa: a systematic review. <i>BMC Public Health.</i> 17(1):174 - 177. http://hdl.handle.net/11427/34361en_ZA
dc.identifier.issn1471-2458
dc.identifier.ris TY - Journal Article AU - Hyle, Emily P AU - Mayosi, Bongani M AU - Middelkoop, Keren AU - Mosepele, Mosepele AU - Martey, Emily B AU - Walensky, Rochelle P AU - Bekker, Linda‐Gail AU - Triant, Virginia A AB - BACKGROUND: Sub-Saharan Africa (SSA) has confronted decades of the HIV epidemic with substantial improvements in access to life-saving antiretroviral therapy (ART). Now, with improved survival, people living with HIV (PLWH) are at increased risk for non-communicable diseases (NCDs), including atherosclerotic cardiovascular disease (CVD). We assessed the existing literature regarding the association of CVD outcomes and HIV in SSA. METHODS: We used the PRISMA guidelines to perform a systematic review of the published literature regarding the association of CVD and HIV in SSA with a focus on CVD surrogate and clinical outcomes in PLWH. RESULTS: From January 2000 until March 2017, 31 articles were published regarding CVD outcomes among PLWH in SSA. Data from surrogate CVD outcomes (n = 13) suggest an increased risk of CVD events among PLWH in SSA. Although acute coronary syndrome is reported infrequently in SSA among PLWH, limited data from five studies suggest extensive thrombus and hypercoagulability as contributing factors. Additional studies suggest an increased risk of stroke among PLWH (n = 13); however, most data are from immunosuppressed ART-naïve PLWH and thus are potentially confounded by the possibility of central nervous system infections. CONCLUSIONS: Given ongoing gaps in our current understanding of CVD and other NCDs in PLWH in SSA, it is imperative to ascertain the burden of CVD outcomes, and to examine strategies for intervention and best practices to enhance the health of this vulnerable population. DA - 2017 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Public Health LK - https://open.uct.ac.za PY - 2017 SM - 1471-2458 T1 - The association between HIV and atherosclerotic cardiovascular disease in sub-Saharan Africa: a systematic review TI - The association between HIV and atherosclerotic cardiovascular disease in sub-Saharan Africa: a systematic review UR - http://hdl.handle.net/11427/34361 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34361
dc.identifier.vancouvercitationHyle EP, Mayosi BM, Middelkoop K, Mosepele M, Martey EB, Walensky RP, et al. The association between HIV and atherosclerotic cardiovascular disease in sub-Saharan Africa: a systematic review. BMC Public Health. 2017;17(1):174 - 177. http://hdl.handle.net/11427/34361.en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.sourceBMC Public Health
dc.source.journalissue1
dc.source.journalvolume17
dc.source.pagination174 - 177
dc.source.urihttps://dx.doi.org/10.1186/s12889-017-4940-1
dc.subject.otherAfrica
dc.subject.otherAtherosclerosis
dc.subject.otherCVD
dc.subject.otherHIV
dc.subject.otherReview
dc.subject.otherAfrica South of the Sahara
dc.subject.otherAtherosclerosis
dc.subject.otherHIV Infections
dc.subject.otherHumans
dc.subject.otherRisk
dc.titleThe association between HIV and atherosclerotic cardiovascular disease in sub-Saharan Africa: a systematic review
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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