Individual characteristics of patients at intermediate or high cardiovascular risk.

<p>Individual characteristics of patients at intermediate or high cardiovascular risk.</p

Dyslipidemias and Elevated Cardiovascular Risk on Lopinavir-Based Antiretroviral Therapy in Cambodia

<div><p>Background</p><p>Lopinavir/ritonavir (LPV/r) is widely used in Cambodia with high efficacy but scarce data exist on long-term metabolic toxicity.</p><p>Methods</p><p>We carried out a cross-sectional and retrospective study evaluating metabolic disorders and cardiovascular risk in Cambodian patients on LPV/r-based antiretroviral therapy (ART) for > 1 year followed in Calmette Hospital, Phnom Penh. Data collected included cardiovascular risk factors, fasting blood lipids and glucose, and retrospective collection of bioclinical data. We estimated the 10-year risks of coronary heart disease with the Framingham, Ramathibodi-Electricity Generating Authority of Thailand (Rama-EGAT), and the Data Collection on Adverse Effects of Anti-HIV Drugs (D:A:D) risk equations. We identified patients with LDL above targets defined by the French expert group on HIV and by the HIV Medicine Association of the Infectious Disease Society of America and the Adult AIDS Clinical Trials Group (IDSA-AACTG).</p><p>Results</p><p>Of 115 patients enrolled—mean age 40.9 years, 69.2% male, mean time on LPV/r 3.8 years—40 (34.8%) had hypercholesterolemia (> 2.40 g/L), and 69 (60.0%) had low HDL cholesterol (< 0.40 g/L). Twelve (10.5%), 28 (24%) and 9 (7.7%) patients had a 10-year risk of coronary heart disease ≥ 10% according to the Framingham, D:A:D, and Rama-EGAT score, respectively. Fifty one (44.4%) and 36 (31.3%) patients had not reached their LDL target according to IDSA-AACTG and French recommendations, respectively.</p><p>Conclusion</p><p>Prevalence of dyslipidemia was high in this cohort of HIV-infected Cambodian patients on LPV/r. Roughly one third had high LDL levels requiring specific intervention.</p></div

Outcomes and predictors used in the Framingham, D:A:D, and Rama-EGAT scoring systems.

<p>Outcomes and predictors used in the Framingham, D:A:D, and Rama-EGAT scoring systems.</p

Agreement between French recommendations and IDSA AACTG recommendations regarding achievement of / treatment decision based on LDL goal related to CV risk level.

<p>Agreement between French recommendations and IDSA AACTG recommendations regarding achievement of / treatment decision based on LDL goal related to CV risk level.</p

Evolution of lipid levels between ART-initiation of antiretroviral treatment, switch to lopinavir/ritonavir and evaluation (N = 70).

<p>Evolution of lipid levels between ART-initiation of antiretroviral treatment, switch to lopinavir/ritonavir and evaluation (N = 70).</p

General characteristics, dyslipidemias, cardiovascular risk factors, risk of coronary heart disease at 10 years, and Low-Density Lipoprotein cholesterol levels based on cardiovascular risk in Cambodian HIV-infected patients on Lopinavir-based ART for 1 year or more (N = 115).

<p>General characteristics, dyslipidemias, cardiovascular risk factors, risk of coronary heart disease at 10 years, and Low-Density Lipoprotein cholesterol levels based on cardiovascular risk in Cambodian HIV-infected patients on Lopinavir-based ART for 1 year or more (N = 115).</p

Individual interview guide for Health care workers, TB-Speed Decentralization study(2018–22).

Individual interview guide for Health care workers, TB-Speed Decentralization study(2018–22).</p

Acceptability of decentralizing a comprehensive childhood tuberculosis diagnosis package in six low-income and high burden countries (2017–2022).

Quotes organised according to the Sekhon Theoretical Framework of Acceptability.</p

Comprehensive childhood tuberculosis diagnosis package.

Comprehensive childhood tuberculosis diagnosis package.</p

Facilitators and barriers to the acceptability of decentralizing a comprehensive childhood tuberculosis diagnosis package (2017–2022).

Facilitators and barriers to the acceptability of decentralizing a comprehensive childhood tuberculosis diagnosis package (2017–2022).</p