Association of HIV and ART with cardiometabolic traits in sub-Saharan Africa: a systematic review and meta-analysis

被引：0

作者：

Dillon, David G. ^{[1
,2
]}

Gurdasani, Deepti ^{[1
,2
]}

Riha, Johanna ^{[1
,2
]}

Ekoru, Kenneth ^{[1
,2
,3
]}

Asiki, Gershim ^{[3
]}

Mayanja, Billy N. ^{[3
]}

Levitt, Naomi S. ^{[4
]}

Crowther, Nigel J. ^{[5
]}

Nyirenda, Moffat ^{[6
]}

Njelekela, Marina ^{[7
]}

Ramaiya, Kaushik ^{[8
]}

Nyan, Ousman ^{[9
]}

Adewole, Olanisun O. ^{[10
]}

Anastos, Kathryn ^{[11
]}

Azzoni, Livio ^{[12
]}

Boom, W. Henry ^{[13
]}

Compostella, Caterina ^{[14
]}

Dave, Joel A. ^{[15
]}

Dawood, Halima ^{[16
]}

Erikstrup, Christian ^{[17
]}

Fourie, Carla M. ^{[18
]}

Friis, Henrik ^{[19
]}

Kruger, Annamarie ^{[20
]}

Idoko, John A. ^{[21
]}

Longenecker, Chris T. ^{[22
]}

Mbondi, Suzanne ^{[23
]}

Mukaya, Japheth E. ^{[24
]}

Mutimura, Eugene ^{[11
]}

Ndhlovu, Chiratidzo E. ^{[25
]}

Praygod, George ^{[26
]}

Yone, Eric W. Pefura ^{[27
]}

Pujades-Rodriguez, Mar ^{[28
,29
]}

Range, Nyagosya ^{[26
]}

Sani, Mahmoud U. ^{[30
]}

Schutte, Aletta E. ^{[18
]}

Sliwa, Karen ^{[31
]}

Tien, Phyllis C. ^{[32
]}

Vorster, Este H. ^{[33
]}

Walsh, Corinna ^{[34
]}

Zinyama, Rutendo ^{[35
]}

Mashili, Fredirick ^{[7
]}

Sobngwi, Eugene ^{[36
,37
]}

Adebamowo, Clement ^{[38
,39
,40
]}

Kamali, Anatoli ^{[3
]}

Seeley, Janet ^{[3
]}

Young, Elizabeth H. ^{[1
,2
]}

Smeeth, Liam ^{[41
]}

Motala, Ayesha A. ^{[42
]}

Kaleebu, Pontiano ^{[3
]}

Sandhu, Manjinder S. ^{[1
,2
]}

机构：

[1] Univ Cambridge, Dept Publ Hlth & Primary Care, Inst Publ Hlth, Cambridge, England

[2] Wellcome Trust Sanger Inst, Genet Epidemiol Grp, Cambridge, England

[3] MRC UVRI Uganda Res Unit AIDS, Entebbe, Uganda

[4] Univ Cape Town, Dept Med, Div Diabet Med & Endocrinol, ZA-7925 Cape Town, South Africa

[5] Univ Witwatersrand, Sch Med, Dept Chem Pathol, Natl Hlth Lab Serv, Johannesburg, South Africa

[6] Malawi Liverpool Wellcome Trust Clin Res Programm, Blantyre, Malawi

[7] Muhimbili Univ Hlth & Allied Sci, Dept Physiol, Dar Es Salaam, Tanzania

[8] Muhimbili Univ Hlth & Allied Sci, Dept Med, Dar Es Salaam, Tanzania

[9] Univ Gambia, Sch Med, Royal Victoria Teaching Hosp, Banjul, Gambia

[10] Obafemi Awolowo Univ, Dept Med, Ife, Nigeria

[11] Womens Equ Access Care & Treatment, Kigali, Rwanda

[12] Wistar Inst Anat & Biol, HIV Immunopathogenesis Lab 1, Philadelphia, PA 19104 USA

[13] Case Western Reserve Univ, Dept Med, TB Res Unit, Cleveland, OH 44106 USA

[14] Univ Padua, Dept Med & Surg Sci, Padua, Italy

[15] Univ Cape Town, Dept Med, Div Diabet Med & Endocrinol, ZA-7925 Cape Town, South Africa

[16] Greys Hosp, Dept Med, Infect Dis Unit, Pietermaritzburg, South Africa

[17] Aarhus Univ Hosp, Dept Clin Immunol, DK-8000 Aarhus, Denmark

[18] North West Univ, HART, Potchefstroom, South Africa

[19] Univ Copenhagen, Fac Sci, Dept Nutr Exercise & Sports, Copenhagen, Denmark

[20] North West Univ, Africa Unit Transdisciplinary Hlth Res AUTHeR, Potchefstroom, South Africa

[21] Jos Univ Teaching Hosp, Dept Med, Jos, Nigeria

[22] Univ Hosp Case Med Ctr, Cleveland, OH USA

[23] German Dev Cooperat GTZ, Yaounde, Cameroon

[24] Makerere Univ, Dept Med, Kampala, Uganda

[25] Univ Zimbabwe, Coll Hlth Sci, Clin Epidemiol Resource Training Ctr, Harare, Zimbabwe

[26] Natl Inst Med Res, Dar Es Salaam, Tanzania

[27] Jamot Hosp, Chest Unit, Yaounde, Cameroon

[28] Medecins Sans Frontieres, Epictr, Paris, France

[29] UCL, Dept Epidemiol & Publ Hlth, Clin Epidemiol Grp, London, England

[30] Aminu Kano Teaching Hosp, Dept Med, Cardiol Unit, Kano, Nigeria

[31] Univ Witwatersrand, Chris Hani Baragwanath Hosp, Soweto Cardiovasc Res Unit, Johannesburg, South Africa

[32] Univ Calif San Francisco, Dept Med, San Francisco, CA USA

[33] North West Univ, Fac Hlth Sci, Potchefstroom, South Africa

[34] Univ Free State, Dept Nutr & Dietet, Bloemfontein, South Africa

[35] Univ Zimbabwe, Dept Med Lab Sci, Med Res Council Zimbabwe, Harare, Zimbabwe

[36] Univ Yaounde I, Fac Med & Biomed Sci, Yaounde, Cameroon

[37] Newcastle Univ, Inst Hlth & Soc, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England

[38] Inst Human Virol, Abuja, Nigeria

[39] Univ Maryland, Sch Med, Inst Human Virol, Dept Epidemiol & Publ Hlth, Baltimore, MD 21201 USA

[40] Univ Maryland, Sch Med, Greenebaum Canc Ctr, Baltimore, MD 21201 USA

[41] London Sch Hyg & Trop Med, Fac Epidemiol & Populat Hlth, London WC1, England

[42] Univ KwaZulu Natal, Nelson R Mandela Sch Med, Dept Endocrinol & Diabet, Durban, South Africa

来源：

INTERNATIONAL JOURNAL OF EPIDEMIOLOGY | 2013年 / 42卷 / 06期

基金：

英国医学研究理事会;

关键词：

HIV; ART; cardiometabolic disease; sub-Saharan Africa; IMMUNODEFICIENCY-VIRUS-INFECTION; ACTIVE ANTIRETROVIRAL THERAPY; REGIONAL ADIPOSE-TISSUE; CORONARY HEART-DISEASE; BLACK SOUTH-AFRICANS; LOW-INCOME COUNTRIES; RISK-FACTORS; CARDIOVASCULAR-DISEASE; BODY-COMPOSITION; PROTEASE INHIBITORS;

D O I：

10.1093/ije/dyt198

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background Sub-Saharan Africa (SSA) has the highest burden of HIV in the world and a rising prevalence of cardiometabolic disease; however, the interrelationship between HIV, antiretroviral therapy (ART) and cardiometabolic traits is not well described in SSA populations. Methods We conducted a systematic review and meta-analysis through MEDLINE and EMBASE (up to January 2012), as well as direct author contact. Eligible studies provided summary or individual-level data on one or more of the following traits in HIV+ and HIV-, or ART+ and ART- subgroups in SSA: body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TGs) and fasting blood glucose (FBG) or glycated hemoglobin (HbA1c). Information was synthesized under a random-effects model and the primary outcomes were the standardized mean differences (SMD) of the specified traits between subgroups of participants. Results Data were obtained from 49 published and 3 unpublished studies which reported on 29 755 individuals. HIV infection was associated with higher TGs [SMD, 0.26; 95% confidence interval (CI), 0.08 to 0.44] and lower HDL (SMD, -0.59; 95% CI, -0.86 to -0.31), BMI (SMD, -0.32; 95% CI, -0.45 to -0.18), SBP (SMD, -0.40; 95% CI, -0.55 to -0.25) and DBP (SMD, -0.34; 95% CI, -0.51 to -0.17). Among HIV+ individuals, ART use was associated with higher LDL (SMD, 0.43; 95% CI, 0.14 to 0.72) and HDL (SMD, 0.39; 95% CI, 0.11 to 0.66), and lower HbA1c (SMD, -0.34; 95% CI, -0.62 to -0.06). Fully adjusted estimates from analyses of individual participant data were consistent with meta-analysis of summary estimates for most traits. Conclusions Broadly consistent with results from populations of European descent, these results suggest differences in cardiometabolic traits between HIV-infected and uninfected individuals in SSA, which might be modified by ART use. In a region with the highest burden of HIV, it will be important to clarify these findings to reliably assess the need for monitoring and managing cardiometabolic risk in HIV-infected populations in SSA.

引用

页码：1754 / 1771

页数：18

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