Cardiovascular disease among people living with HIV in Brazil

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorBOETTIGER, David C.
dc.contributor.authorESCUDER, Maria Mercedes
dc.contributor.authorLAW, Matthew G.
dc.contributor.authorVELOSO, Valdilea
dc.contributor.authorSOUZA, Rosa A.
dc.contributor.authorIKEDA, Maria L. R.
dc.contributor.authorALENCASTRO, Paulo R. de
dc.contributor.authorTUPINAMBAS, Unai
dc.contributor.authorBRITES, Carlos
dc.contributor.authorGRINSZTEJN, Beatriz
dc.contributor.authorGGOMES, Jackeline O.
dc.contributor.authorRIBEIRO, Sayonara
dc.contributor.authorMCGOWAN, Catherine C.
dc.contributor.authorJAYATHILAKE, Karu
dc.contributor.authorCASTILHO, Jessica L.
dc.contributor.authorGRANGEIRO, Alexandre
dc.contributor.groupauthorHIV-Brazil Cohort Study
dc.date.accessioned2020-08-20T13:26:15Z
dc.date.available2020-08-20T13:26:15Z
dc.date.issued2020
dc.description.abstractObjectives There is a paucity of data on cardiovascular disease (CVD) among people living with HIV (PLHIV) in resource-limited countries. We assessed factors associated with CVD and the impact of prevalent CVD on all-cause mortality in PLHIV on antiretroviral therapy in Brazil. Methods Competing risk regression to assess factors associated with CVD and all-cause mortality in the HIV-Brazil Cohort Study between 2003 and 2014. Results Among 5614 patients, the rate of CVD was 3.5 (95% confidence interval [95% CI] 2.9-4.3) per 1000 person-years. CVD was associated with older age (adjusted hazard ratio [aHR] 6.4 for >= 55 years vs. <35 years, 95% CI: 2.5-16.3, P < 0.01), black race (aHR 1.8 vs. white race, 95% CI: 1.0-3.1, P = 0.04), past CVD (aHR 3.0 vs. no past CVD, 95% CI: 1.4-6.2, P < 0.01), hypertension (aHR 1.8 vs. no hypertension, 95% CI: 1.0-3.1, P = 0.04), high-grade dyslipidemia (aHR 9.3 vs. no high-grade dyslipidemia, 95% CI: 6.0-14.6, P < 0.01), ever smoking (aHR 2.4 vs. never, 95% CI: 1.2-5.0, P = 0.02) and low nadir CD4 cell count (aHR 1.8 for 100-250 cells/mm(3) vs. >250 cells/mm(3), 95% CI: 1.0-3.2, P = 0.05). The rate of death was 16.6 (95% CI: 15.1-18.3) per 1000 person-years. Death was strongly associated with having had a past CVD event (aHR 1.7 vs. no past CVD event, 95% CI: 1.1-2.7, P = 0.01). Conclusions Traditional and HIV-specific factors associated with CVD among PLHIV in Brazil are similar to those identified among PLHIV in high-income countries. PLHIV in Brazil with a history of CVD have a high risk of death. CVD care and treatment remain priorities for PLHIV in Brazil as this population ages and antiretroviral therapy use expands.eng
dc.description.indexMEDLINEeng
dc.description.sponsorshipBrazilian National Council for Scientific & Technological Development
dc.description.sponsorshipBrazilian National Ministry of Health
dc.description.sponsorshipPan American Health Organization
dc.description.sponsorshipU.S. National Institutes of Health (NIH)United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [K23AI1120875, P30AI110527]
dc.description.sponsorshipNIHUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [U01AI069923]
dc.description.sponsorshipEunice Kennedy Shriver National Institute Of Child Health & Human Development (NICHD)United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
dc.description.sponsorshipNational Cancer Institute (NCI)United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Cancer Institute (NCI)
dc.description.sponsorshipNational Institute Of Allergy And Infectious Diseases (NIAID)United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of Allergy & Infectious Diseases (NIAID)
dc.description.sponsorshipNational Institute Of Mental Health (NIMH)United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of Mental Health (NIMH)
dc.description.sponsorshipOffice Of The Director, National Institutes Of Health (OD)United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA
dc.identifier.citationTROPICAL MEDICINE & INTERNATIONAL HEALTH, v.25, n.7, p.886-896, 2020
dc.identifier.doi10.1111/tmi.13405
dc.identifier.eissn1365-3156
dc.identifier.issn1360-2276
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/37058
dc.language.isoeng
dc.publisherWILEYeng
dc.relation.ispartofTropical Medicine & International Health
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright WILEYeng
dc.subjectHIVeng
dc.subjectcardiovascular diseaseeng
dc.subjectmortalityeng
dc.subjectBrazileng
dc.subjectantiretroviral therapyeng
dc.subject.otheracute myocardial-infarctioneng
dc.subject.otherlong-term survivaleng
dc.subject.othernational-health surveyeng
dc.subject.otherabacavir useeng
dc.subject.otherantiretroviral therapieseng
dc.subject.otherincreased riskeng
dc.subject.otherpopulationeng
dc.subject.othermortalityeng
dc.subject.othereventseng
dc.subject.otherindividualseng
dc.subject.wosPublic, Environmental & Occupational Healtheng
dc.subject.wosTropical Medicineeng
dc.titleCardiovascular disease among people living with HIV in Brazileng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.affiliation.countryAustrália
hcfmusp.affiliation.countryEstados Unidos
hcfmusp.affiliation.countryisoau
hcfmusp.affiliation.countryisous
hcfmusp.author.externalBOETTIGER, David C.:Univ Calif San Francisco, Inst Hlth Policy Studies, 3333 Calif St, San Francisco, CA 94143 USA; Univ New South Wales, Kirby Inst, Sydney, NSW, Australia
hcfmusp.author.externalESCUDER, Maria Mercedes:Inst Hlth, Sao Paulo State Dept Hlth, Sao Paulo, Brazil
hcfmusp.author.externalLAW, Matthew G.:Univ New South Wales, Kirby Inst, Sydney, NSW, Australia
hcfmusp.author.externalVELOSO, Valdilea:Fundacao Oswaldo Cruz, Natl Inst Infectol Evandro Chagas, Rio De Janeiro, Brazil
hcfmusp.author.externalSOUZA, Rosa A.:AIDS Reference & Training Ctr, Sao Paulo State Dept Hlth, Sao Paulo, Brazil
hcfmusp.author.externalIKEDA, Maria L. R.:Univ Vale Rio dos Sinos, Sch Hlth, Porto Alegre, RS, Brazil
hcfmusp.author.externalALENCASTRO, Paulo R. de:Hosp Sanatorio Partenon, Rio Grande Sul State Dept Hlth, Care & Treatment Clin, Porto Alegre, RS, Brazil
hcfmusp.author.externalTUPINAMBAS, Unai:Univ Fed Minas Gerais, Med Sch, Belo Horizonte, MG, Brazil
hcfmusp.author.externalBRITES, Carlos:Univ Fed Bahia, Edgar Santos Univ Hosp Complex, Salvador, BA, Brazil
hcfmusp.author.externalGRINSZTEJN, Beatriz:Fundacao Oswaldo Cruz, Natl Inst Infectol Evandro Chagas, Rio De Janeiro, Brazil
hcfmusp.author.externalGGOMES, Jackeline O.:Inst Hlth, Sao Paulo State Dept Hlth, Sao Paulo, Brazil
hcfmusp.author.externalRIBEIRO, Sayonara:Fundacao Oswaldo Cruz, Natl Inst Infectol Evandro Chagas, Rio De Janeiro, Brazil
hcfmusp.author.externalMCGOWAN, Catherine C.:Vanderbilt Univ, Med Ctr, Div Infect Dis, Nashville, TN USA
hcfmusp.author.externalJAYATHILAKE, Karu:Vanderbilt Univ, Med Ctr, Div Infect Dis, Nashville, TN USA
hcfmusp.author.externalCASTILHO, Jessica L.:Vanderbilt Univ, Med Ctr, Div Infect Dis, Nashville, TN USA
hcfmusp.citation.scopus8
hcfmusp.contributor.author-fmusphcALEXANDRE DOMINGUES GRANGEIRO
hcfmusp.description.beginpage886
hcfmusp.description.endpage896
hcfmusp.description.issue7
hcfmusp.description.volume25
hcfmusp.origemWOS
hcfmusp.origem.pubmed32306480
hcfmusp.origem.scopus2-s2.0-85084489639
hcfmusp.origem.wosWOS:000531433900001
hcfmusp.publisher.cityHOBOKENeng
hcfmusp.publisher.countryUSAeng
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