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Prevention of cardiovascular disease among people living with HIV in sub-Saharan Africa.
Progress in Cardiovascular Diseases ( IF 9.1 ) Pub Date : 2020-02-05 , DOI: 10.1016/j.pcad.2020.02.004
Samson Okello 1 , Abdallah Amir 2 , Gerald S Bloomfield 3 , Katie Kentoffio 4 , Henry M Lugobe 5 , Zahra Reynolds 6 , Itai M Magodoro 7 , Crystal M North 8 , Emmy Okello 9 , Robert Peck 10 , Mark J Siedner 11
Affiliation  

As longevity has increased for people living with HIV (PLWH) in the United States and Europe, there has been a concomitant increase in the prevalence of cardiovascular disease (CVD) risk factors and morbidity in this population. Whereas the availability of HIV antiretroviral therapy has resulted in dramatic increases in life expectancy in sub-Saharan Africa (SSA), where over two thirds of PLWH reside, if and how these trends impact the epidemiology of CVD is less clear. In this review, we describe the current state of the science on how both HIV and its treatment impact CVD risk factors and outcomes among PLWH in sub-Saharan Africa, including regional factors (unique to SSA) likely to differentiate these relationships from the global North. We then outline how current regional guidelines address CVD prevention among PLWH and which clinical and structural interventions are best poised to confront the co-epidemics of HIV and CVD in the region. We conclude with a discussion of key research gaps that need to be addressed to optimally develop an actionable public health response.

中文翻译:

撒哈拉以南非洲艾滋病毒感染者的心血管疾病预防。

随着美国和欧洲艾滋病毒感染者 (PLWH) 寿命的延长,该人群心血管疾病 (CVD) 危险因素的患病率和发病率也随之增加。虽然艾滋病毒抗逆转录病毒疗法的出现使撒哈拉以南非洲地区 (SSA) 的预期寿命急剧增加,三分之二以上的感染者居住在该地区,但这些趋势是否以及如何影响 CVD 的流行病学尚不清楚。在这篇综述中,我们描述了艾滋病毒及其治疗如何影响撒哈拉以南非洲艾滋病病毒感染者的心血管疾病危险因素和结果的科学现状,包括可能将这些关系与全球北方区分开来的区域因素(SSA独有) 。然后,我们概述了当前的区域指南如何解决 PLWH 中的 CVD 预防问题,以及哪些临床和结构干预措施最适合应对该地区 HIV 和 CVD 的共同流行。最后,我们讨论了需要解决的关键研究差距,以最佳地制定可行的公共卫生应对措施。
更新日期:2020-02-05
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