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2030-12-31
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- INI - Artigos de Periódicos [3648]
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ASSOCIATION OF CARDIOVASCULAR DISEASE RISK WITH LIVER STEATOSIS AND FIBROSIS IN PEOPLE WITH HIV IN LOW- AND MIDDLE-INCOME COUNTRIES
Author
Kuniholm, Mark H.
Murenzi, Gad
Shumbusho, Fabienne
Brazier, Ellen
Plaisy, Marie K.
Mensah, Ephrem
Wandeler, Gilles
Riebensahm, Carlotta
Chihota, Belinda V.
Samala, Niharika
Diero, Lameck
Semeere, Aggrey S.
Chanyachukul, Thida
Borse, Rohidas
Nguyen, Dung T. H.
Perazzo, Hugo
Lopez-Iniguez, Alvaro
Castilho, Jessica L.
Maruri, Fernanda
Jaquet, Antoine
Murenzi, Gad
Shumbusho, Fabienne
Brazier, Ellen
Plaisy, Marie K.
Mensah, Ephrem
Wandeler, Gilles
Riebensahm, Carlotta
Chihota, Belinda V.
Samala, Niharika
Diero, Lameck
Semeere, Aggrey S.
Chanyachukul, Thida
Borse, Rohidas
Nguyen, Dung T. H.
Perazzo, Hugo
Lopez-Iniguez, Alvaro
Castilho, Jessica L.
Maruri, Fernanda
Jaquet, Antoine
Affilliation
State University of New York. University at Albany. Department of Epidemiology and Biostatistics. Rensselaer, New York, USA.
Research for Development (RD Rwanda). Rwanda / Rwanda Military Hospital. Kigali, Rwanda.
Research for Development (RD Rwanda). Rwanda / Rwanda Military Hospital. Kigali, Rwanda.
Institute for Implementation Science in Population Health. New York, NY, USA / City University of New York. Graduate School of Public Health and Health Policy. New York, New York, USA.
National Institute for Health and Medical Research. Research Institute for Sustainable Development. University of Bordeaux. Bordeaux Population Health Centre. Bordeaux, France.
Espoir Vie-Togo. Lome, Togo.
Bern University Hospital. Inselspital. Department of Infectious Diseases. Bern, Switzerland / University of Bern. Institute of Social and Preventive Medicine. Bern, Switzerland.
Bern University Hospital. Inselspital. Department of Infectious Diseases. Bern, Switzerland / University of Bern. Institute of Social and Preventive Medicine. Bern, Switzerland.
University of Bern. Institute of Social and Preventive Medicine. Bern, Switzerland / Centre for Infectious Disease Research in Zambia. Lusaka, Zambia.
Indiana University. Department of Medicine. Division of Gastroenterology and Hepatology. Indianapolis, Indiana, USA.
Moi University. AMPATH. Eldoret, Kenya.
Makerere University. College of Health Sciences. Infectious Diseases Institute. Kampala, Uganda.
TREAT Asia/amfAR - The Foundation for AIDS Research. Bangkok, Thailand.
B. J. Government Medical College & Sassoon General Hospitals. Pune, Maharashtra, India.
National Hospital for Tropical Diseases. Department of Infectious Diseases. Hanoi, Vietnam.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST e AIDS. Rio de Janeiro, RJ, Brasil.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Mexico City, Mexico.
Vanderbilt University Medical Center. Department of Medicine. Division of Infectious Diseases. Nashville, Tennessee, USA.
Vanderbilt University Medical Center. Department of Medicine. Division of Infectious Diseases. Nashville, Tennessee, USA.
National Institute for Health and Medical Research. Research Institute for Sustainable Development. University of Bordeaux. Bordeaux Population Health Centre. Bordeaux, France.
Research for Development (RD Rwanda). Rwanda / Rwanda Military Hospital. Kigali, Rwanda.
Research for Development (RD Rwanda). Rwanda / Rwanda Military Hospital. Kigali, Rwanda.
Institute for Implementation Science in Population Health. New York, NY, USA / City University of New York. Graduate School of Public Health and Health Policy. New York, New York, USA.
National Institute for Health and Medical Research. Research Institute for Sustainable Development. University of Bordeaux. Bordeaux Population Health Centre. Bordeaux, France.
Espoir Vie-Togo. Lome, Togo.
Bern University Hospital. Inselspital. Department of Infectious Diseases. Bern, Switzerland / University of Bern. Institute of Social and Preventive Medicine. Bern, Switzerland.
Bern University Hospital. Inselspital. Department of Infectious Diseases. Bern, Switzerland / University of Bern. Institute of Social and Preventive Medicine. Bern, Switzerland.
University of Bern. Institute of Social and Preventive Medicine. Bern, Switzerland / Centre for Infectious Disease Research in Zambia. Lusaka, Zambia.
Indiana University. Department of Medicine. Division of Gastroenterology and Hepatology. Indianapolis, Indiana, USA.
Moi University. AMPATH. Eldoret, Kenya.
Makerere University. College of Health Sciences. Infectious Diseases Institute. Kampala, Uganda.
TREAT Asia/amfAR - The Foundation for AIDS Research. Bangkok, Thailand.
B. J. Government Medical College & Sassoon General Hospitals. Pune, Maharashtra, India.
National Hospital for Tropical Diseases. Department of Infectious Diseases. Hanoi, Vietnam.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST e AIDS. Rio de Janeiro, RJ, Brasil.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Mexico City, Mexico.
Vanderbilt University Medical Center. Department of Medicine. Division of Infectious Diseases. Nashville, Tennessee, USA.
Vanderbilt University Medical Center. Department of Medicine. Division of Infectious Diseases. Nashville, Tennessee, USA.
National Institute for Health and Medical Research. Research Institute for Sustainable Development. University of Bordeaux. Bordeaux Population Health Centre. Bordeaux, France.
Abstract
Objective: The aim of this study was to understand the relationship between cardiovascular disease (CVD) risk and liver steatosis and fibrosis among people with HIV (PLWH) at least 40 years of age on antiretroviral therapy (ART) in low and middle-income countries (LMIC). Design: We used cross-sectional behavioral and clinical data collected during study enrollment visits in 2020-2022 for the Sentinel Research Network of International epidemiology Databases to Evaluate AIDS (SRN of IeDEA). Methods: Ten-year CVD risk was calculated using 2019 WHO nonlaboratory and laboratory models. Transient elastography was used to assess liver disease. Presence of steatosis and significant fibrosis were defined by controlled attenuation parameter (CAP) at least 248 dB/m and liver stiffness measurement (LSM) at least 7.1 kPa, respectively. Participants with viral hepatitis, hazardous alcohol consumption, and unsuppressed HIV viral load were excluded from the analysis. Logistic regression was used to estimate odds ratios, adjusting for study site, CD4 + T cell count, stavudine and didanosine exposure, and in models stratified by sex and geographic region. Results: There were 1750 participants from nine LMIC. Median CVD risk was 3% for both nonlaboratory and laboratory-based models. Adjusted odds ratios (ORs) for steatosis and significant fibrosis associated with laboratory CVD risk (≥10 vs. <5%) were OR = 1.83 [95% confidence interval (95% CI) = 1.21-2.76; P = 0.004] and OR = 1.62 (95% CI = 0.85-3.07; P = 0.14), respectively. Associations of CVD risk with steatosis were stronger in men and among participants at study sites outside Africa. Conclusion: Higher CVD risk was associated with steatosis but not with significant fibrosis in PWH in our LMIC cohort.
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