Cardiovascular risk and endothelial function in people living with HIV/AIDS: design of the multi-site, longitudinal EndoAfrica study in the Western Cape Province of South Africa
Date
2017-01-07
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
Background: There is growing evidence of an interaction between HIV-infection, anti-retroviral therapy (ART) and
cardiovascular diseases (CVD). Epidemiological studies in Europe and North America have been observing a shift
towards an increased incidence of coronary heart disease and acute myocardial infarctions in HIV-infected populations
compared to the general population even after adjusting for traditional cardiovascular risk factors. Despite South Africa
(and sub-Saharan Africa, SSA) being regarded as the epicentre of the global HIV epidemic, very little is known about
the prevalence of cardiovascular risk factors and precursors of vascular disease in HIV-infected populations in this
region. The knowledge gap is further widened by the paucity of data from prospective studies. We present the
rationale, objectives and key methodological features of the EndoAfrica study, which aims to determine whether HIVinfection
and ART are associated with altered cardiovascular risk and changes in vascular endothelial structure and
function in adults living in the Western Cape Province of South Africa.
Methods: In this longitudinal study, comprehensive cardiovascular assessments of HIV-negative and HIV-positive (with
and without ART) study participants are performed by clinical and biochemical screening for traditional cardiovascular
risk factors and biomarkers of CVD. Vascular and endothelial function is determined by brachial artery flow-mediated
dilatation (FMD), carotid-intima-thickness (IMT) measurements and quantitative retinal blood vessel analyses,
complemented by vascular endothelial biomarker assays. Finally, we aim to statistically determine whether HIVinfection
and/or ART are associated with increased cardiovascular risk and vascular endothelial dysfunction, and
determine whether there is progression/regression in these endpoints 18 months after the baseline assessments.
Discussion: The EndoAfrica study provides a unique opportunity to recruit a cohort of HIV-infected patients and HIVnegative
controls who will be comprehensively and longitudinally assessed for cardiovascular risk and disease profile
with vascular endothelial function as a potentially important intermediate cardiovascular phenotype. To our
knowledge, it is the first time that such a systematic study has been established in the context of SSA and South Africa.
Description
CITATION: Strijdom, H., et al. 2017. Cardiovascular risk and endothelial function in people living with HIV/AIDS: design of the multi-site, longitudinal EndoAfrica study in the Western Cape Province of South Africa. BMC Infectious Diseases, 17:41, doi:10.1186/s12879-016-2158-y.
The original publication is available at http://bmcinfectdis.biomedcentral.com
The original publication is available at http://bmcinfectdis.biomedcentral.com
Keywords
Cardiovascular system -- Diseases -- Risk factors, Antiretroviral drugs, Vascular endothelial, HIV patients
Citation
Strijdom, H., et al. 2017. Cardiovascular risk and endothelial function in people living with HIV/AIDS: design of the multi-site, longitudinal EndoAfrica study in the Western Cape Province of South Africa. BMC Infectious Diseases, 17:41, doi:10.1186/s12879-016-2158-y