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Inflammation-mediated vitamin K and vitamin D effects on vascular calcifications in people with HIV on active antiretroviral therapy
Background: People with HIV (PWH) experience increased systemic inflammation and monocyte activation, leading to increased risk of cardiovascular events (death, stroke, and myocardial infarction) and higher coronary artery calcium scores (CACs). Vitamins D and K2 have significant anti-inflammatory effects; in addition, vitamin K2 is involved in preventing vascular calcifications in the general population. The roles of vitamins D and K in increased coronary calcifications in successfully treated PWH is less understood. Methods: We prospectively recruited 237 PWH on antiretroviral treatment (ART) and 67 healthy co...
Source: AIDS - March 25, 2022 Category: Infectious Diseases Tags: CLINICAL SCIENCE Source Type: research

Intracranial vascular imaging detects arterial wall abnormalities in persons with treated HIV infection
Conclusion: In persons at moderate-to-high cardiovascular risk, HIV infection, even when well controlled, may be associated with a greater burden of intracranial large artery disease and, specifically, of ICAD. Studies of the mechanisms underlying higher rates of ischemic stroke in PWH should include evaluation for intracranial large artery disease. VW-MRI provides added value as an adjunct to traditional luminal imaging when evaluating cerebrovascular risk in PWH.
Source: AIDS - December 14, 2021 Category: Infectious Diseases Tags: CLINICAL SCIENCE: CONCISE COMMUNICATIONS Source Type: research

Plasma galectin-9 as a predictor of adverse non-AIDS events in persons with chronic HIV during suppressive antiretroviral therapy
Background: People with HIV (PWH) on antiretroviral therapy (ART) still experience an increased risk of morbidity and mortality, presumably driven by chronic inflammation, yet predictors of discrete or combinatorial outcomes remain unclear. Galectin-9 (Gal-9), a driver of both inflammatory and immunosuppressive responses, has been associated with HIV disease progression and multimorbidity. Objective: To determine whether plasma Gal-9 levels are associated with the occurrence of specific non-AIDS events (NAEs) in PWH initiating ART. Design: We performed a nested case–control study of PWH enrolled from 20...
Source: AIDS - November 23, 2021 Category: Infectious Diseases Tags: CLINICAL SCIENCE: CONCISE COMMUNICATION Source Type: research

Risk factors and outcomes of HIV-associated stroke in Zambia
Objective: To compare risk factors and clinical outcomes between people with HIV (PWH) and HIV-uninfected (HIV−) adults with stroke hospitalized in Zambia. Methods: We retrospectively reviewed charts of all adults admitted to the University Teaching Hospital in Lusaka, Zambia with a clinical diagnosis of stroke between October 2018 and March 2019. Standardized data collection instruments were used to collect demographic, clinical, laboratory and imaging results. Comparison between individuals with and without HIV infection was made using t tests for continuous parametric variables, Wilcoxon rank-sum tests for ...
Source: AIDS - October 12, 2021 Category: Infectious Diseases Tags: CLINICAL SCIENCE Source Type: research

Presence of asymptomatic cytomegalovirus and Epstein--Barr virus DNA in blood of persons with HIV starting antiretroviral therapy is associated with non-AIDS clinical events
Background: Even with antiretroviral therapy (ART), persons with HIV (PWH) experience increased morbidity and mortality. Cytomegalovirus (CMV) and Epstein--Barr virus (EBV) co-infections likely exacerbate inflammatory-related diseases. Objective: To determine if presence of detectable CMV or EBV DNA in peripheral blood mononuclear cells (PBMC) is associated with non-AIDS events among PWH receiving modern ART. Design: We performed a case--control study of PWH starting ART and HIV-suppressed at year 1 and thereafter, 140 cases who experienced non-AIDS events and 305 matched controls. Events included myocardial infarc...
Source: AIDS - April 9, 2020 Category: Infectious Diseases Tags: CLINICAL SCIENCE Source Type: research

Soluble suppression of tumorigenicity 2 levels are not predictive of non-AIDS events during antiretroviral therapy-mediated viral suppression
Before initiation of antiretroviral therapy (ART), levels of soluble suppression of tumorigenicity 2 (sST2) were not elevated in people living with HIV who later developed non-AIDS events (including myocardial infarction and stroke), compared with controls. However, higher sST2 levels measured pre-ART were a significant predictor of death while on ART. Future studies should explore the potential of sST2 to serve as a short-term predictor of non-AIDS events during viral suppression.
Source: AIDS - June 3, 2019 Category: Infectious Diseases Tags: Research Letters Source Type: research

Death after diagnosis of noncommunicable disease comorbid conditions, stratified by injection drug use
Conclusion: Persons with a history of injection drug use and non-IDU had strikingly similar risk and hazard of mortality after several major NCD diagnoses. Mortality after cancer diagnosis in this cohort was higher for persons with a history of IDU than those without; this may be because of being diagnosed with a different mix of specific sites and stages of cancers.
Source: AIDS - December 20, 2018 Category: Infectious Diseases Tags: Epidemiology and Social Source Type: research

Stroke incidence is highest in women and non-Hispanic blacks living with HIV in the AIDS Clinical Trials Group Longitudinal Linked Randomized Trials cohort
Conclusion: Women and non-Hispanic Blacks living with HIV had the highest incidence rates of stroke/TIA. A concerted effort must be made to include PLWH from these at-risk groups in observational and interventional studies aimed at understanding stroke mechanisms and reducing stroke risk in HIV infection. Strategies to modify stroke risk in PLWH should employ a multipronged approach targeting vascular risk factors and engaging and retaining patients in HIV care.
Source: AIDS - May 11, 2018 Category: Infectious Diseases Tags: Clinical Science Source Type: research

The growing burden of noncommunicable disease among persons living with HIV in Zimbabwe
Conclusion: NCD services will need to be expanded in Zimbabwe. They will need to be integrated into HIV care programmes, although the growing NCD burden amongst uninfected individuals presenting opportunities for additional services developed within HIV care to benefit HIV-negative persons.
Source: AIDS - March 16, 2018 Category: Infectious Diseases Tags: Epidemiology and Social Source Type: research

Elevated ischemic stroke risk among women living with HIV infection
Conclusion: The increased risk of ischemic stroke among WLWH compared with HIV-uninfected women persisted after adjusting for both traditional and sex-specific stroke risk factors. Further investigation into the mechanisms of elevated stroke risk among WLWH, including immunologic factors, will be key for developing targeted preventive strategies for this at-risk population.
Source: AIDS - December 1, 2017 Category: Infectious Diseases Tags: Clinical Science Source Type: research

Cardiovascular outcomes among HIV-infected veterans receiving atazanavir
Conclusion: Among treatment-naive HIV-infected patients in the Veterans Health Administration initiating ATV-containing regimens, risk of both MI and stroke were significantly lower than in those initiating regimens containing other protease inhibitors, NNRTIs, or INSTIs.
Source: AIDS - September 15, 2017 Category: Infectious Diseases Tags: Clinical Science Source Type: research

Impact of aging on neurocognitive performance in previously antiretroviral-naive HIV-infected individuals on their first suppressive regimen
Conclusion: Despite continued virologic suppression and neurocognitive improvement in the cohort as a whole, older individuals were more likely to have neurocognitive impairment than younger individuals.
Source: AIDS - June 30, 2017 Category: Infectious Diseases Tags: Clinical Science Source Type: research

Inflammation, immune activation, and cardiovascular disease in HIV
Cardiovascular disease is one of the leading causes of morbidity and mortality in people living with HIV. Several epidemiological studies have shown an increased risk of myocardial infarction and stroke compared to uninfected controls. Although traditional risk factors contribute to this increased risk of cardiovascular disease, HIV-specific mechanisms likely also play a role. Systemic inflammation has been linked to cardiovascular disease in several populations suffering from chronic inflammation, including people living with HIV. Although antiretroviral therapy reduces immune activation, levels of inflammatory markers re...
Source: AIDS - June 2, 2016 Category: Infectious Diseases Tags: Editorial Review Source Type: research

Association of injection drug use with incidence of HIV-associated non-AIDS-related morbidity by age, 1995–2014
Conclusion: Not all HANA comorbidities occur with higher incidence in PWID compared with non-IDU. However, higher incidence of ESRD and ESLD among PWIDs highlights the importance of recognition and management of markers of these comorbidities in early stages among PWID.
Source: AIDS - May 13, 2016 Category: Infectious Diseases Tags: Epidemiology and Social Source Type: research

Effect of CD4+ cell count and viral suppression on risk of ischemic stroke in HIV infection
Conclusion:Achieving viral suppression may reduce ischemic stroke risk, including risk of atherosclerotic strokes, in HIV-infected individuals.
Source: AIDS - October 31, 2014 Category: Infectious Diseases Tags: Clinical Science: Concise Communications Source Type: research