Author | Boettiger, David C. | |
Author | Escuder, Maria Mercedes | |
Author | Law, Matthew G. | |
Author | Veloso, Valdiléa G. | |
Author | Souza, Rosa A. | |
Author | Ikeda, Maria L. R. | |
Author | Alencastro, Paulo R. | |
Author | Tupinambás, Unai | |
Author | Brites, Carlos | |
Author | Grinsztejn, Beatriz | |
Author | Ggomes, Jackeline O. | |
Author | Ribeiro, Sayonara | |
Author | McGowan, Catherine C. | |
Author | Jayathilake, Karu | |
Author | Castilho, Jessica L. | |
Author | Grangeiro, Alexandre | |
Access date | 2020-05-13T23:00:11Z | |
Available date | 2020-05-13T23:00:11Z | |
Document date | 2020 | |
Citation | BOETTIGER, David C. et al. Cardiovascular disease among people living with HIV in Brazil. Tropical Medicine and International Health, p. 1-22, 2020. | pt_BR |
ISSN | 1360-2276 | pt_BR |
URI | https://www.arca.fiocruz.br/handle/icict/41235 | |
Language | eng | pt_BR |
Publisher | Wiley | pt_BR |
Later version | https://www.arca.fiocruz.br/handle/icict/42422 | |
Rights | open access | pt_BR |
Title | Cardiovascular disease among people living with HIV in Brazil | pt_BR |
Type | Preprint | pt_BR |
DOI | 10.1111/tmi.13405 | |
Abstract | 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. Competing risk regression to assess factors associated with CVD and all-cause mortality in the HIV-Brazil Cohort Study between 2003 and 2014. 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). 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. | pt_BR |
Affilliation | University of California. Institute for Health Policy Studies. San Francisco, CA, USA / University of New South Wales. Kirby Institute. Sydney, Australia. | pt_BR |
Affilliation | Secretaria de Saúde do Estado de São Paulo. Instituto de Saúde. São Paulo, SP, Brasil. | pt_BR |
Affilliation | University of New South Wales. Kirby Institute. Sydney, Australia. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Secretaria de Saúde do Estado de São Paulo. Centro de Referência e Treinamento em Aids. São Paulo, SP, Brasil. | pt_BR |
Affilliation | Universidade do Vale do Rio dos Sinos. Faculdade de Saúde. Porto Alegre, RS, Brasil. | pt_BR |
Affilliation | Departamento de Saúde do Rio Grande do Sul. Clínica de Cuidados e Tratamento do Hospital Sanatório Partenon. Porto Alegre, RS, Brasil. | pt_BR |
Affilliation | Universidade Federal de Minas Gerais. Faculdade de Medicina. Belo Horizonte, MG, Brasil. | pt_BR |
Affilliation | Universidade Federal da Bahia. Complexo Hospitalar da Universidade Edgar Santos. Salvador, BA, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Secretaria de Saúde do Estado de São Paulo. Instituto de Saúde. São Paulo, SP, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Vanderbilt University Medical Center. Division of Infectious Diseases. Nashville, TN, USA. | pt_BR |
Affilliation | Vanderbilt University Medical Center. Division of Infectious Diseases. Nashville, TN, USA. | pt_BR |
Affilliation | Vanderbilt University Medical Center. Division of Infectious Diseases. Nashville, TN, USA. | pt_BR |
Affilliation | Vanderbilt University Medical Center. Division of Infectious Diseases. Nashville, TN, USA. | pt_BR |
Affilliation | Universidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Preventiva. São Paulo, SP, Brasil. | pt_BR |
Subject | Brazil | pt_BR |
Subject | HIV | pt_BR |
Subject | Antiretroviral therapy | pt_BR |
Subject | Cardiovascular disease | pt_BR |
Subject | Mortality | pt_BR |
Embargo date | 2022-12-31 | |