HIV, HIV-specific Factors and Myocardial Disease in Women
© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com..
BACKGROUND: People with HIV (PWH) have an increased risk of cardiovascular disease (CVD). Cardiac magnetic resonance (CMR) has documented higher myocardial fibrosis, inflammation and steatosis in PWH, but studies have mostly relied on healthy volunteers as comparators and focused on men.
METHODS: We investigated the associations of HIV and HIV-specific factors with CMR phenotypes in female participants enrolled in the Women's Interagency HIV Study's New York and San Francisco sites. Primary phenotypes included myocardial native (n) T1 (fibro-inflammation), extracellular volume fraction (ECV, fibrosis) and triglyceride content (steatosis). Associations were evaluated with multivariable linear regression, and results pooled or meta-analyzed across centers.
RESULTS: Among 261 women with HIV (WWH, total n = 362), 76.2% had undetectable viremia at CMR. For the 82.8% receiving continuous antiretroviral therapy (ART) in the preceding 5 years, adherence was 51.7%, and 71.3% failed to achieve persistent viral suppression (42.2% with peak viral load < 200 cp/mL). Overall, WWH showed higher nT1 than women without HIV (WWOH) after full adjustment. This higher nT1 was more pronounced in those with antecedent or current viremia or nadir CD4+ count < 200 cells/μL, the latter also associated with higher ECV. WWH and current CD4+ count < 200 cells/μL had less cardiomyocyte steatosis. Cumulative exposure to specific ART showed no associations.
CONCLUSIONS: Compared with sociodemographically similar WWOH, WWH on ART exhibit higher myocardial fibro-inflammation, which is more prominent with unsuppressed viremia or CD4+ lymphopenia. These findings support the importance of improved ART adherence strategies, along with better understanding of latent infection, to mitigate cardiac end-organ damage in this population.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America - (2024) vom: 13. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kato, Yoko [VerfasserIn] |
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| Links: |
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| Themen: |
Antiretroviral therapy |
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| Anmerkungen: |
Date Revised 15.02.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1093/cid/ciae077 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368462579 |
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| 100 | 1 | |a Kato, Yoko |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a HIV, HIV-specific Factors and Myocardial Disease in Women |
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| 520 | |a © The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com. | ||
| 520 | |a BACKGROUND: People with HIV (PWH) have an increased risk of cardiovascular disease (CVD). Cardiac magnetic resonance (CMR) has documented higher myocardial fibrosis, inflammation and steatosis in PWH, but studies have mostly relied on healthy volunteers as comparators and focused on men | ||
| 520 | |a METHODS: We investigated the associations of HIV and HIV-specific factors with CMR phenotypes in female participants enrolled in the Women's Interagency HIV Study's New York and San Francisco sites. Primary phenotypes included myocardial native (n) T1 (fibro-inflammation), extracellular volume fraction (ECV, fibrosis) and triglyceride content (steatosis). Associations were evaluated with multivariable linear regression, and results pooled or meta-analyzed across centers | ||
| 520 | |a RESULTS: Among 261 women with HIV (WWH, total n = 362), 76.2% had undetectable viremia at CMR. For the 82.8% receiving continuous antiretroviral therapy (ART) in the preceding 5 years, adherence was 51.7%, and 71.3% failed to achieve persistent viral suppression (42.2% with peak viral load < 200 cp/mL). Overall, WWH showed higher nT1 than women without HIV (WWOH) after full adjustment. This higher nT1 was more pronounced in those with antecedent or current viremia or nadir CD4+ count < 200 cells/μL, the latter also associated with higher ECV. WWH and current CD4+ count < 200 cells/μL had less cardiomyocyte steatosis. Cumulative exposure to specific ART showed no associations | ||
| 520 | |a CONCLUSIONS: Compared with sociodemographically similar WWOH, WWH on ART exhibit higher myocardial fibro-inflammation, which is more prominent with unsuppressed viremia or CD4+ lymphopenia. These findings support the importance of improved ART adherence strategies, along with better understanding of latent infection, to mitigate cardiac end-organ damage in this population | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a HIV | |
| 650 | 4 | |a Women's Interagency HIV Study (WIHS) | |
| 650 | 4 | |a antiretroviral therapy | |
| 650 | 4 | |a cardiac magnetic resonance | |
| 650 | 4 | |a myocardial fibro-inflammation | |
| 700 | 1 | |a Ambale-Venkatesh, Bharath |e verfasserin |4 aut | |
| 700 | 1 | |a Naveed, Mahim |e verfasserin |4 aut | |
| 700 | 1 | |a Shitole, Sanyog G |e verfasserin |4 aut | |
| 700 | 1 | |a Peng, Qi |e verfasserin |4 aut | |
| 700 | 1 | |a Levsky, Jeffrey M |e verfasserin |4 aut | |
| 700 | 1 | |a Haramati, Linda B |e verfasserin |4 aut | |
| 700 | 1 | |a Ordovas, Karen |e verfasserin |4 aut | |
| 700 | 1 | |a Noworolski, Susan M |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Yoo Jin |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Ryung S |e verfasserin |4 aut | |
| 700 | 1 | |a Lazar, Jason M |e verfasserin |4 aut | |
| 700 | 1 | |a Anastos, Kathryn |e verfasserin |4 aut | |
| 700 | 1 | |a Tien, Phyllis C |e verfasserin |4 aut | |
| 700 | 1 | |a Kaplan, Robert C |e verfasserin |4 aut | |
| 700 | 1 | |a Lima, Joao A C |e verfasserin |4 aut | |
| 700 | 1 | |a Kizer, Jorge R |e verfasserin |4 aut | |
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