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Title: Cardiovascular disease among people living with HIV in Brazil
Authors: BOETTIGER, David C.ESCUDER, Maria MercedesLAW, Matthew G.VELOSO, ValdileaSOUZA, Rosa A.IKEDA, Maria L. R.ALENCASTRO, Paulo R. deTUPINAMBAS, UnaiBRITES, CarlosGRINSZTEJN, BeatrizGGOMES, Jackeline O.RIBEIRO, SayonaraMCGOWAN, Catherine C.JAYATHILAKE, KaruCASTILHO, Jessica L.GRANGEIRO, Alexandre
Citation: TROPICAL MEDICINE & INTERNATIONAL HEALTH, v.25, n.7, p.886-896, 2020
Abstract: Objectives 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.
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Artigos e Materiais de Revistas Científicas - FM/Outros
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Artigos e Materiais de Revistas Científicas - ODS/03
ODS/03 - Saúde e bem-estar

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