Cardiovascular disease among people living with HIV in Brazil
| Autor(a) principal: | |
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| Data de Publicação: | 2020 |
| Outros Autores: | , , , , , , , , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
| Texto Completo: | https://www.arca.fiocruz.br/handle/icict/42422 |
Resumo: | The HIV-Brazil Cohort Study was supported by the Brazilian National Council for Scientific & Technological Development, Brazilian National Ministry of Health, and Pan American Health Organization. The study was supported in part by the U.S. National Institutes of Health (NIH) (K23AI1120875 and P30AI110527) and the NIHfunded Caribbean, Central and South America network for HIV epidemiology (CCASAnet), a member cohort of the International epidemiology Databases to Evaluate AIDS (leDEA) (U01AI069923). This award is funded by the following institutes: Eunice Kennedy Shriver National Institute Of Child Health & Human Development (NICHD), National Cancer Institute (NCI), National Institute Of Allergy And Infectious Diseases (NIAID), National Institute Of Mental Health (NIMH), and the Office Of The Director, National Institutes Of Health (OD). |
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Boettiger, David C.Escuder, Maria MercedesLaw, Matthew G.Veloso, Valdiléa G.Souza, Rosa A.Ikeda, Maria L. R.Alencastro, Paulo R.Tupinambás, UnaiBrites, CarlosGrinsztejn, BeatrizGgomes, Jackeline O.Ribeiro, SayonaraMcGowan, Catherine C.Jayathilake, KaruCastilho, Jessica L.Grangeiro, Alexandre2020-07-28T17:09:08Z2020-07-28T17:09:08Z2020BOETTIGER, David C. et al. Cardiovascular disease among people living with HIV in Brazil. Tropical Medicine & International Health, v. 25, n. 7, p. 1-18, 2020.1360-2276https://www.arca.fiocruz.br/handle/icict/4242210.1111/tmi.13405The HIV-Brazil Cohort Study was supported by the Brazilian National Council for Scientific & Technological Development, Brazilian National Ministry of Health, and Pan American Health Organization. The study was supported in part by the U.S. National Institutes of Health (NIH) (K23AI1120875 and P30AI110527) and the NIHfunded Caribbean, Central and South America network for HIV epidemiology (CCASAnet), a member cohort of the International epidemiology Databases to Evaluate AIDS (leDEA) (U01AI069923). This award is funded by the following institutes: Eunice Kennedy Shriver National Institute Of Child Health & Human Development (NICHD), National Cancer Institute (NCI), National Institute Of Allergy And Infectious Diseases (NIAID), National Institute Of Mental Health (NIMH), and the Office Of The Director, National Institutes Of Health (OD).Objectifs: Il existe peu de données sur les maladies cardiovasculaires (MCV) chez les personnes vivant avec le VIH (PVVIH) dans les pays à ressources limitées. Nous avons évalué les facteurs associés aux MCV et l'impact des MCV prévalentes sur la mortalité toutes causes confondues des PVVIH sous le traitement antirétroviral au Brésil. MÉTHODES: Régression des risques concurrente pour évaluer les facteurs associés aux MCV et à la mortalité toutes causes confondues dans l'étude de cohorte VIH-Brésil entre 2003 et 2014. RÉSULTATS: Parmi 5.614 patients, le taux de MCV était de 3,5 (intervalle de confiance à 95% [IC95%] 2,9-4,3) pour 1.000 personnes-années. Les MCV étaient associées à un âge plus avancé (rapport de risque ajusté [aHR] 6,4 chez les ≥55 ans versus chez les <35 ans, IC95%: 2,5-16,3 ; p <0,01), race noire (aHR: 1,8 versus race blanche, IC95%: 1,0-3,1 ; p = 0,04), MCV passée (aHR: 3,0 versus pas de MCV passée, IC95%: 1,4-6,2 ; p <0,01), hypertension (aHR: 1,8 versus pas d'hypertension, IC95%: 1,0-3,1 ; p = 0,04), dyslipidémie de grade élevé (aHR 9,3 versus absence de dyslipidémie de grade élevé, IC95%: 6,0-14,6 ; p <0,01), tabagisme (aHR 2,4 versus n’avoir jamais fumé, IC95%: 1,2-5,0 ; p = 0,02) et faible nombre de CD4 au nadir (aHR: 1,8 pour 100-250 cellules/mm3 versus >250 cellules/mm3 , IC95%: 1,0-3,2 ; p = 0,05). Le taux de décès était de 16,6 (IC95%: 15,1-18,3) pour 1.000 personnes-années. Le décès était fortement associé à un événement MCV antérieur (aHR: 1,7 versus aucun événement MCV antérieur, IC95%: 1,1-2,7 ; p = 0,01). Conclusions: Les facteurs traditionnels et spécifiques au VIH associés aux MCV chez les PVVIH au Brésil sont similaires à ceux identifiés chez les PVVIH dans les pays à revenu élevé. Les PVVIH au Brésil ayant des antécédents de MCV ont un risque élevé de décès. Les soins et le traitement des MCV restent des priorités pour les PVVIH au Brésil à mesure que cette population vieillit et que l'utilisation des thérapies antirétrovirales augmente.2022-12-31University of California. Institute for Health Policy Studies. San Francisco, CA, USA / University of New South Wales. Kirby Institute. Sydney, Australia.Institute of Health. São Paulo State Department of Health. São Paulo, SP, Brazil.University of New South Wales. Kirby Institute. Sydney, Australia.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.AIDS Reference and Training Center. São Paulo State Department of Health. São Paulo, SP, Brazil.University do Vale do Rio dos Sinos. School of Health. Porto Alegre, RS, Brazil.Rio Grande do Sul State Department of Health. Care and Treatment Clinic of the Hospital Sanatório Partenon. Porto Alegre, RS, Brazil.Federal University of Minas Gerais. Medical School. Belo Horizonte, MG, Brazil.Federal University of Bahia. Edgar Santos University Hospital Complex. Salvador, BA, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Institute of Health. São Paulo State Department of Health. São Paulo, SP, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Vanderbilt University Medical Center. Division of Infectious Diseases. Nashville, TN, USA.Vanderbilt University Medical Center. Division of Infectious Diseases. Nashville, TN, USA.Vanderbilt University Medical Center. Division of Infectious Diseases. Nashville, TN, USA.University of São Paulo. School of Medicine. Department of Preventive Medicine. São Paulo, SP, Brazil.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/mm3 vs. >250 cells/mm3 , 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.engWileyhttps://www.arca.fiocruz.br/handle/icict/41235Cardiovascular disease among people living with HIV in Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleBrazilHIVAntiretroviral therapyCardiovascular diseaseMortalityBrésilVIHTraitement antirétroviralMaladie cardiovasculaireMortalitéinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZORIGINALve_Boettiger_David_etal_ENSP_2020.pdfve_Boettiger_David_etal_ENSP_2020.pdfapplication/pdf245678https://www.arca.fiocruz.br/bitstream/icict/42422/2/ve_Boettiger_David_etal_ENSP_2020.pdf60c0324c0abedeb6688793de8e864c6dMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-83099https://www.arca.fiocruz.br/bitstream/icict/42422/1/license.txt586c046dcfeef936e32f0323bb9a47c0MD51icict/424222023-06-19 21:58:14.123oai:www.arca.fiocruz.br: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ório 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| dc.title.pt_BR.fl_str_mv |
Cardiovascular disease among people living with HIV in Brazil |
| title |
Cardiovascular disease among people living with HIV in Brazil |
| spellingShingle |
Cardiovascular disease among people living with HIV in Brazil Boettiger, David C. Brazil HIV Antiretroviral therapy Cardiovascular disease Mortality Brésil VIH Traitement antirétroviral Maladie cardiovasculaire Mortalité |
| title_short |
Cardiovascular disease among people living with HIV in Brazil |
| title_full |
Cardiovascular disease among people living with HIV in Brazil |
| title_fullStr |
Cardiovascular disease among people living with HIV in Brazil |
| title_full_unstemmed |
Cardiovascular disease among people living with HIV in Brazil |
| title_sort |
Cardiovascular disease among people living with HIV in Brazil |
| author |
Boettiger, David C. |
| author_facet |
Boettiger, David C. Escuder, Maria Mercedes Law, Matthew G. Veloso, Valdiléa G. Souza, Rosa A. Ikeda, Maria L. R. Alencastro, Paulo R. Tupinambás, Unai Brites, Carlos Grinsztejn, Beatriz Ggomes, Jackeline O. Ribeiro, Sayonara McGowan, Catherine C. Jayathilake, Karu Castilho, Jessica L. Grangeiro, Alexandre |
| author_role |
author |
| author2 |
Escuder, Maria Mercedes Law, Matthew G. Veloso, Valdiléa G. Souza, Rosa A. Ikeda, Maria L. R. Alencastro, Paulo R. Tupinambás, Unai Brites, Carlos Grinsztejn, Beatriz Ggomes, Jackeline O. Ribeiro, Sayonara McGowan, Catherine C. Jayathilake, Karu Castilho, Jessica L. Grangeiro, Alexandre |
| author2_role |
author author author author author author author author author author author author author author author |
| dc.contributor.author.fl_str_mv |
Boettiger, David C. Escuder, Maria Mercedes Law, Matthew G. Veloso, Valdiléa G. Souza, Rosa A. Ikeda, Maria L. R. Alencastro, Paulo R. Tupinambás, Unai Brites, Carlos Grinsztejn, Beatriz Ggomes, Jackeline O. Ribeiro, Sayonara McGowan, Catherine C. Jayathilake, Karu Castilho, Jessica L. Grangeiro, Alexandre |
| dc.subject.en.pt_BR.fl_str_mv |
Brazil HIV Antiretroviral therapy Cardiovascular disease Mortality |
| topic |
Brazil HIV Antiretroviral therapy Cardiovascular disease Mortality Brésil VIH Traitement antirétroviral Maladie cardiovasculaire Mortalité |
| dc.subject.fr.pt_BR.fl_str_mv |
Brésil VIH Traitement antirétroviral Maladie cardiovasculaire Mortalité |
| description |
The HIV-Brazil Cohort Study was supported by the Brazilian National Council for Scientific & Technological Development, Brazilian National Ministry of Health, and Pan American Health Organization. The study was supported in part by the U.S. National Institutes of Health (NIH) (K23AI1120875 and P30AI110527) and the NIHfunded Caribbean, Central and South America network for HIV epidemiology (CCASAnet), a member cohort of the International epidemiology Databases to Evaluate AIDS (leDEA) (U01AI069923). This award is funded by the following institutes: Eunice Kennedy Shriver National Institute Of Child Health & Human Development (NICHD), National Cancer Institute (NCI), National Institute Of Allergy And Infectious Diseases (NIAID), National Institute Of Mental Health (NIMH), and the Office Of The Director, National Institutes Of Health (OD). |
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2020 |
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2020-07-28T17:09:08Z |
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2020-07-28T17:09:08Z |
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2020 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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BOETTIGER, David C. et al. Cardiovascular disease among people living with HIV in Brazil. Tropical Medicine & International Health, v. 25, n. 7, p. 1-18, 2020. |
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https://www.arca.fiocruz.br/handle/icict/42422 |
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1360-2276 |
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10.1111/tmi.13405 |
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BOETTIGER, David C. et al. Cardiovascular disease among people living with HIV in Brazil. Tropical Medicine & International Health, v. 25, n. 7, p. 1-18, 2020. 1360-2276 10.1111/tmi.13405 |
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Wiley |
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Wiley |
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