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: | por |
Título da fonte: | Repositório Institucional da UFMG |
Texto Completo: | http://hdl.handle.net/1843/47478 |
Resumo: | 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. |
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2022-11-25T20:01:57Z2022-11-25T20:01:57Z202025788689610.1111/tmi.1340513602276http://hdl.handle.net/1843/474780000-0001-6833-3870OBJECTIVES—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.OBJETIVOS—Existe uma escassez de dados sobre doenças cardiovasculares (DCV) entre pessoas vivendo com HIV (PVHIV) em países com recursos limitados. Avaliamos os fatores associados à DCV e o impacto da DCV prevalente na mortalidade por todas as causas em PVHIV em terapia antirretroviral no Brasil. MÉTODOS—Regressão de risco competitivo para avaliar fatores associados a DCV e mortalidade por todas as causas no Estudo de Coorte HIV-Brasil entre 2003 e 2014. RESULTADOS—Entre 5.614 pacientes, a taxa de DCV foi de 3,5 (intervalo de confiança de 95% [IC 95%] 2,9–4,3) por 1.000 pessoas-ano. A DCV foi associada à idade avançada (taxa de risco ajustada [aHR] 6,4 para ≥55 anos vs. <35 anos, IC 95%: 2,5–16,3, P < 0,01), raça negra (aHR 1,8 vs. raça branca, 95% CI : 1,0–3,1, P = 0,04), DCV anterior (aHR 3,0 vs. sem DCV anterior, IC 95%: 1,4–6,2, P < 0,01), hipertensão (aHR 1,8 vs. sem hipertensão, IC 95%: 1,0–3,1 , P = 0,04), dislipidemia de alto grau (aHR 9,3 vs. sem dislipidemia de alto grau, 95% CI: 6,0–14,6, P < 0,01), sempre fumante (aHR 2,4 vs. nunca, 95% CI: 1,2–5,0, P = 0,02) e nadir baixo de células CD4 contagem (aHR 1,8 para 100–250 células/mm3 vs. >250 células/mm3, 95% CI: 1,0–3,2, P = 0,05). A taxa de mortalidade foi de 16,6 (95% CI: 15,1–18,3) por 1.000 pessoas-ano. A morte foi fortemente associada a um evento anterior de DCV (aHR 1,7 vs. nenhum evento CVD passado, IC 95%: 1,1–2,7, P = 0,01). CONCLUSÕES—Os fatores tradicionais e específicos do HIV associados às DCV entre PVHIV no Brasil são semelhantes aos identificados entre PVHIV em países de alta renda. PVHIV no Brasil com história de DCV tem alto risco de morte. O cuidado e o tratamento de DCV continuam sendo prioridades para PVHIV no Brasil, à medida que essa população envelhece e o uso de terapia antirretroviral se expande.porUniversidade Federal de Minas GeraisUFMGBrasilMED - DEPARTAMENTO DE CLÍNICA MÉDICATropical Medicine & International HealthHIVTerapia Antirretroviral de Alta AtividadeMortalidadeDoenças CardiovascularesBrasilHIVMortalityBrazilCardiovascular diseaseAntiretroviral therapyCardiovascular disease among people living with HIV in BrazilDoença cardiovascular entre pessoas vivendo com HIV no Brasilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7547667/pdf/nihms-1633584.pdfDavid C.BoettigerBeatriz GrinsztejnJackeline O. GomesSayonara RibeiroCatherine C. McgowanKaru JayathilakeJessica L. CastilhoAlexandre GrangeiroMaria Mercedes EscuderMatthew G. LawValdiléa VelosoRosa A. SouzaMaria L. R. IkedaPaulo R. AlencastroUnaí TupinambásCarlos Britesapplication/pdfinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/47478/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINALCardiovascular disease among people living with HIV in Brazil.pdfCardiovascular disease among people living with HIV in Brazil.pdfapplication/pdf349429https://repositorio.ufmg.br/bitstream/1843/47478/2/Cardiovascular%20disease%20among%20people%20living%20with%20HIV%20in%20Brazil.pdf9eb334839b74fc6b373e936b8e339839MD521843/474782022-11-30 17:30:54.711oai:repositorio.ufmg.br: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Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2022-11-30T20:30:54Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.pt_BR.fl_str_mv |
Cardiovascular disease among people living with HIV in Brazil |
dc.title.alternative.pt_BR.fl_str_mv |
Doença cardiovascular entre pessoas vivendo com HIV no Brasil |
title |
Cardiovascular disease among people living with HIV in Brazil |
spellingShingle |
Cardiovascular disease among people living with HIV in Brazil David C.Boettiger HIV Mortality Brazil Cardiovascular disease Antiretroviral therapy HIV Terapia Antirretroviral de Alta Atividade Mortalidade Doenças Cardiovasculares Brasil |
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 |
David C.Boettiger |
author_facet |
David C.Boettiger Beatriz Grinsztejn Jackeline O. Gomes Sayonara Ribeiro Catherine C. Mcgowan Karu Jayathilake Jessica L. Castilho Alexandre Grangeiro Maria Mercedes Escuder Matthew G. Law Valdiléa Veloso Rosa A. Souza Maria L. R. Ikeda Paulo R. Alencastro Unaí Tupinambás Carlos Brites |
author_role |
author |
author2 |
Beatriz Grinsztejn Jackeline O. Gomes Sayonara Ribeiro Catherine C. Mcgowan Karu Jayathilake Jessica L. Castilho Alexandre Grangeiro Maria Mercedes Escuder Matthew G. Law Valdiléa Veloso Rosa A. Souza Maria L. R. Ikeda Paulo R. Alencastro Unaí Tupinambás Carlos Brites |
author2_role |
author author author author author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
David C.Boettiger Beatriz Grinsztejn Jackeline O. Gomes Sayonara Ribeiro Catherine C. Mcgowan Karu Jayathilake Jessica L. Castilho Alexandre Grangeiro Maria Mercedes Escuder Matthew G. Law Valdiléa Veloso Rosa A. Souza Maria L. R. Ikeda Paulo R. Alencastro Unaí Tupinambás Carlos Brites |
dc.subject.por.fl_str_mv |
HIV Mortality Brazil Cardiovascular disease Antiretroviral therapy |
topic |
HIV Mortality Brazil Cardiovascular disease Antiretroviral therapy HIV Terapia Antirretroviral de Alta Atividade Mortalidade Doenças Cardiovasculares Brasil |
dc.subject.other.pt_BR.fl_str_mv |
HIV Terapia Antirretroviral de Alta Atividade Mortalidade Doenças Cardiovasculares Brasil |
description |
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. |
publishDate |
2020 |
dc.date.issued.fl_str_mv |
2020 |
dc.date.accessioned.fl_str_mv |
2022-11-25T20:01:57Z |
dc.date.available.fl_str_mv |
2022-11-25T20:01:57Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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http://hdl.handle.net/1843/47478 |
dc.identifier.doi.pt_BR.fl_str_mv |
10.1111/tmi.13405 |
dc.identifier.issn.pt_BR.fl_str_mv |
13602276 |
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0000-0001-6833-3870 |
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10.1111/tmi.13405 13602276 0000-0001-6833-3870 |
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http://hdl.handle.net/1843/47478 |
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por |
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por |
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Tropical Medicine & International Health |
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openAccess |
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Universidade Federal de Minas Gerais |
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UFMG |
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Brasil |
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MED - DEPARTAMENTO DE CLÍNICA MÉDICA |
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Universidade Federal de Minas Gerais |
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