Correction to: Association of HIV-infection, antiretroviral treatment and metabolic syndrome with large artery stiffness: A cross-sectional study (BMC Infectious Diseases (2018) 18 (708) DOI: 10.1186/s12879-018-3637-0)

Following publication of the original article [1], the authors reported that they have provided the wrong caption. In Fig. 1 the caption should be "Blood pressure-and sex-adjusted aortic pulse wave velocity (a) and aortic augmentation index (b) in the controls, HIV-1-naive and HIV-1-cART patients with and without metabolic yndrome". 2) The remaining sentence "Aortic pulse wave velocity was 25%( P = 0.018) and 21% ( P = 0.023) higher in the HIV-1 cART patients compared with both controls and untreated HIV-1 patients, respectively. There was no significant main effect of metabolic syndrome on augmentation index between the three groups. Values are mean ± SD. ∗ P = 0.009 versus HIV-1 cART patients without metabolic syndrome" should be added to at the end of paragraph "Aortic pulse wave velocity in patients with metabolic Syndrome". (3) The heading "sIndependent predictors of large elastic artery stiffness" should be replaced with "Independent predictors of large elastic artery stiffness". It has been corrected in the original article as well. The publisher apologizes for any inconvenience caused by this error

Antiretroviral Treatment and Time Since HIV-1 Diagnosis are Associated with Large Artery Stiffness in Sub-Saharan African HIV-1 Patients

Background:HIV-1 infection in northern populations is associated with increased large artery stiffness, both in the absence and presence of combination antiretroviral treatment (cART). It is unclear if similar changes occur in sub-Sahara African HIV-infected persons. The study aimed to determine whether HIV-1 infection with and without cART is associated with large artery stiffness in a cohort of HIV-1-infected patients in Tanzania.Methods: In this cross-sectional study, 146 subjects were recruited: 40 uninfected controls, 51 HIV-1-infected untreated persons, and 55 on cART for at least 12 months. Patients were screened for history of hepatic, renal, haematological or cardiovascular disease, diabetes, dyslipoproteinaemia, and hypertension. Following screening, 4 untreated and 21 cART HIV-1 patients were excluded; leaving 47 HIV-1-infected untreated and 34 cART patients to be studied. cART included first line treatment: lamivudine/zidovudine with nevirapine or efavirenz. Large artery stiffness was assessed using applanation tonometry via pulse wave analysis to determine aortic pulse wave velocity (aPWV) and augmentation index corrected to a heart rate of 75 bpm (AIx@HR75).Results: Aortic PWV was higher (p = 0.017) in the HIV-1-infected patients on cART (aPWV: 8.2 ± 1.8 m/s) vs. untreated patients (7.3 ± 1.5 m/s) and independent of blood pressure differences. AIx@HR75 was significantly increased in cART HIV-1 (29 ± 8%) vs. untreated HIV-1 patients (23 ± 10%; p = 0.038) and controls (23 ± 10%; p = 0.032). Duration of HIV-1 and cART were independent predictors of arterial stiffening in HIV-1 patients.Conclusions: The surrogate markers for arterial stiffness suggest an increased cardiovascular risk in sub-Saharan African HIV-1 patients on first line therapy

Association of HIV-infection, antiretroviral treatment and metabolic syndrome with large artery stiffness: a cross-sectional study

Abstract Background Effective combined antiretroviral therapy (cART) has improved life expectancy among people living with HIV-1 infection. Treated HIV-1infection increases the prevalence of metabolic syndrome (MS). Despite sub-Saharan Africa having among the highest rates of HIV-1 infection, the effects of MS in HIV-1-infected individuals on cardiovascular risk is poorly explored. The aim of the study was to assess whether MS and/or HIV-1 treatment correlates with large elastic artery stiffness in HIV-1-infected patients treated with first-line cART. Methods The study sample comprised of 102 subjects free of cardiovascular disease and major risk factors divided into two groups based on HIV-1 infection, treatment, and MS status: HIV-1+/cART+/MS+ (n = 12); HIV-1+/cART−/MS+ (n = 16); HIV-1−/ MS+ (n = 10); HIV-1+/cART+/MS− (n = 42); HIV-1+/cART−/MS− (n = 32); HIV-1−/ MS− (n = 39). MS was established according the International Diabetes Federation definition. Large artery stiffness was measured using applanation tonometry to assess aortic pulse wave velocity (aPWV) and aortic augmentation index at heart rate of 75 bpm (AIx@HR75). cART included lamivudine/zidovudine and nevirapine or efavirenz. Results The prevalence of MS in the HIV-1-infected patients was 28%. There were no significant differences in aPWV in the non-MS groups. However, in subjects with MS, aPWV was significantly higher in the HIV-1 cART patients (9.0 ± 1.9 m/s) compared with both controls (7.5 ± 1.8 m/s; P = 0.018) and untreated HIV-1 patients (7.7 ± 1.3 m/s; P = 0.023), and these differences remained after adjustment for blood pressure and sex. Aortic PWV was significantly elevated (P = 0.009) in HIV-1 cART patients with MS compared to their counterparts without MS. Untreated HIV-1 patients with MS also demonstrated increased aPWV compared to their counterparts without MS (P = 0.05). Aortic AIx@HR75 was, on average, ~ 5% higher in HIV-1 cART patients with MS (28.3 ± 62% compared with untreated HIV-1 patients with MS (23.5 ± 9%; P = 0.075). Sub-group multivariate analysis identified MS as an independent predictor of increased aPWV in HIV-1 cART patients. Conclusions Our study established that presence of MS in HIV-1 patients on treatment was associated with increased aPWV and hence increased arterial stiffness in sub-Saharan African HIV-1 patients on first-line cART

Comparison of predicted cardiovascular risk profiles by different CVD risk-scoring algorithms between HIV-1-infected and uninfected adults: a cross-sectional study in Tanzania

Purpose: Cardiovascular disease (CVD) risk assessment is a suitable way to differentiate between high-risk individuals requiring intervention and risk modification, and those at low risk. However, concerns have been raised when adopting a CVD-risk prediction algorithm for HIV-infected patients in sub-Saharan Africa. Patients and Methods: We compared cardiovascular risk profiles between HIV-infected (with and without antiretroviral therapy (ART)) and HIV-uninfected adults as predicted by the American College of Cardiology/American Heart Association (ASCVD) and the Framingham cardiovascular risk score (FRS) algorithms and assessed the concordance of the algorithms in predicting 10-year CVD risk separately in HIV-infected and uninfected groups in a hospital-based cross-sectional study in Tanzania. A cross-sectional hospital-based study including 40 HIV-infected ART-naive, 64 HIV-infected on ART, and 50 HIV-uninfected adults was conducted. Traditional cardiovascular risk factors were determined by standard investigations. The primary outcome was the absolute 10year CVD risk score based on the two algorithms. Results: Compared to HIV-uninfected, HIV-infected adults were classified at a higher 10year CVD risk. ASCVD algorithms predicted a higher proportion of high-risk individuals compared to FRS in both HIV-infected and uninfected groups. The concordance between ASCVD and FRS-lipid algorithms was reasonable for both HIV-infected and uninfected groups though relatively higher in the HIV-uninfected group. Conclusion: HIV-infected individuals have a higher 10-year cardiovascular risk compared to HIV-uninfected persons. The concordance between ASCVD and FRS-lipid algorithms is reasonable in both HIV-uninfected and infected persons in Tanzania. Development of an HIV-specific algorithm is needed to accurately predict CVD risk in this population at highrisk

The effect of HIV infection, antiretroviral therapy on carotid intima-media thickness: A systematic review and meta-analysis

Aims: We performed a systematic review and meta-analysis on the effect of HIV infection and antiretroviral therapy (ART) on carotid intima-media thickness (cIMT) to elucidate the role of HIV infection and ART. Also, an analysis on the role of ethnicity and gender on cIMT in HIV-infected populations was performed. Main methods: We searched the PubMed, Web of Science, the WHO websites and International AIDS Society for published observational studies were conducted by two independent reviewers for studies comparing HIV-infected antiretroviral-experienced patients and/or inexperienced with healthy controls on cIMT. The primary outcome was the standardized mean difference (SMD) of cIMT. Findings: Twenty studies (five cohort, 15 cross-sectional, and two both cohort and cross-sectional studies) were identified comprising 7948 subjects (4656 HIV-infected; 3292 controls). In cohort studies, the standardized mean 1-year change in cIMT between HIV-infected patients and uninfected controls was not significantly different (0.16 mm/yr; 95% CI, −0.16, 0.49; p = 0.326). In 17 cross-sectional studies, the SMD in cIMT was significantly higher in HIV-infected than uninfected persons (0.27 mm; 95% CI, 0.04, 0.49; p = 0.027). HIV-infected patients on ART exhibited significantly higher SMD in cIMT compared to those not on ART (0.75 mm; 95% CI, 0.30, 1.19; p = 0.001). No confounding effect of gender and ethnicity could be established using meta-regression p > 0.05. Significance: HIV infection itself and ART appear to influence the progression of cIMT and hence may be risk factors for cardiovascular events. No firm conclusions could be drawn on the effect of ethnic/race and gender differences on cIMT in HIV-infected populations