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

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.accessioned2018-01-08T13:43:03Z
dc.date.available2018-01-08T13:43:03Z
dc.date.issued2017-12-15
dc.date.updated2017-12-17T04:53:07Z
dc.description.abstractackground: 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. http://hdl.handle.net/11427/26745en_ZA
dc.identifier.chicagocitationHyle, Emily P, Bongani M Mayosi, Keren Middelkoop, Mosepele Mosepele, Emily B Martey, Rochelle P Walensky, Linda-Gail Bekker, and Virginia A Triant "The association between HIV and atherosclerotic cardiovascular disease in sub-Saharan Africa: a systematic review." (2017) http://hdl.handle.net/11427/26745en_ZA
dc.identifier.citationHyle, 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. BMC public health, 17(1), 954.
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 - ackground: 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 - 2017-12-15 DB - OpenUCT DO - 10.1186/s12889-017-4940-1 DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2017 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/11427/26745 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1186/s12889-017-4940-1
dc.identifier.urihttp://hdl.handle.net/11427/26745
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. 2017; http://hdl.handle.net/11427/26745.en_ZA
dc.language.isoen
dc.publisherBioMed Central
dc.publisher.departmentDepartment of Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rights.holderThe Author(s).
dc.subject.otherHIV
dc.subject.otherCVD
dc.subject.otherAtherosclerosis
dc.subject.otherAfrica
dc.subject.otherReview
dc.titleThe association between HIV and atherosclerotic cardiovascular disease in sub-Saharan Africa: a systematic review
dc.typeJournal Article
uct.type.filetypeText
uct.type.filetypeImage
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