Suchergebnisse

Chronic inflammation is an HIV infection feature, contributing to elevated risk of cardiovascular disease among people with HIV, which can be induced by viral replication. A proportion of antiretroviral therapy (ART) recipients fail to achieve viral suppression, despite not meeting criteria for treatment failure, so-called low-level viremia (LLV). We investigated the relationship between LLV and an array of cardiovascular measures and biomarkers. South Africans with LLV (viral load = 50-999 copies/mL) and virological suppression (viral load <50 copies/mL) were selected from the EndoAfrica study (all receiving efavirenz-based ART) for cross-sectional comparison of vascular structure and function measures, as well as 21 plasma biomarkers related to cardiovascular risk and inflammation. Associations were investigated with univariate, multivariate, and binomial logistic regression analyses (having outcome measures above (cases) or below (controls) the 75th percentile). Among 208 participants, 95 (46%) had LLV, and 113 (54%) had viral suppression. The median age was 44 years, 73% were women, and the median ART duration was 4.5 years. Cardiovascular measures and biomarker levels were similar between these two categories. Cardiovascular function and structure measures were not associated with viremia status and having LLV did not increase the odds of having outcome measures above the 75th percentile. In this study among South African ART recipients, LLV did not associate with cardiovascular risk. ; The EndoAfrica study received funding under the ERAfrica call in the EU 7th Framework Program. Funding was distributed by the Department of Science and Innovation in South Africa (contract number for North West: DSI/CON 0133/2016 and for Western Cape: DSI/CON 0077/2014), the Belgian Science Policy in Belgium (contract number BL/67/eranet03), and Österreichische Agentur für internationale Mobilitätund Kooperation in Bildung, Wissenschaft und Forschung, OeAD GmbH (ÖAD) in Austria (Grant number: KEF-Projekt P202). The Knut ...

Background: People from low- and middle-income countries are disproportionately affected by the global burden of adverse health effects caused by ambient air pollution (AAP). However, data from Sub-Saharan Africa (SSA) are still scarce. We systematically reviewed the literature to describe the existing knowledge on AAP and health outcomes in SSA. Methods: We searched PubMed, Medline-OVID, EMBASE and Scopus databases to identify studies of AAP and health outcomes published up to November 15, 2017. We used a systematic review approach to critically analyze and summarize levels of outdoor air pollutants, and data on health effects associated with AAP. We excluded occupational and indoor exposure studies. Results: We identified 60 articles, with 37 only describing levels of AAP and 23 assessing the association between air pollution and health outcomes. Most studies (75%) addressing the relation between AAP and disease were cross-sectional. In general, exposure data were only obtained for selected cities in the framework of temporary international collaborative research initiatives without structural long-term continuation. Measurements of AAP revealed 10-20 fold higher levels than WHO standards. Of the 23 studies reporting health effects, 14 originated from South Africa, and most countries within SSA contributed no data at all. No studies, except from South Africa, were based on reliable morbidity or mortality statistics at regional or country level. The majority of studies investigated self-reported respiratory symptoms. Children and the elderly were found to be more susceptible to AAP. Conclusion: AAP and its negative health effects have been understudied in SSA compared with other continents. The limited direct measurements of air pollutants indicate that AAP in SAA cities is high compared with international standards. Efforts are needed to monitor AAP in African cities, to identify its main sources, and to reduce adverse health effects by enforcing legislation. ; This research did not receive any specific grant from fundingagenciesinthepublic,commercial,ornot-for-profitsectors

Exposure to ambient NO2 and benzene, toluene ethyl-benzene and m+p- and o-xylenes (BTEX) is associated with adverse cardiovascular effects, but limited information is available on the effects of personal exposure to these compounds in South African populations. This 6-month follow-up study aims to determine 7-day personal ambient NO2 and BTEX exposure levels via compact passive diffusion samplers in female participants from Cape Town, and investigate whether exposure levels are associated with cardiovascular risk markers. Overall, the measured air pollutant exposure levels were lower compared to international standards. NO2 was positively associated with systolic and diastolic blood pressure (SBP and DBP), and inversely associated with the central retinal venular equivalent (CRVE) and mean baseline brachial artery diameter. o-xylene was associated with DBP and benzene was strongly associated with carotid intima media thickness (cIMT). Our findings showed that personal air pollution exposure, even at relatively low levels, was associated with several markers of cardiovascular risk in women residing in the Cape Town region. ; This research was funded by the ERAfrica program of the EU 7th Framework Program (Grant number: IC-003), Department of Science and Technology in South Africa (Grant number: DST/CON 0077/2014), The Belgian Science Policy in Belgium (Grant number BL/67/eranet03), and the Osterreichische Agentur fur internationale Mobilitat und Kooperation in Bildung, Wissenschaft und Forschung, OeAD GmbH (OAD) in Austria (Grant number: KEF-Projekt P202). In addition, Frans Everson received a grant from Hasselt University in the context of BILA (bilateral) collaboration with Stellenbosch University (BOF16BL05).

Limited information on the effect of antiretroviral treatment (ART) on vascular function in South Africans of African descent living with human immunodeficiency virus (HIV) is available. The relationship between ART, vascular function and cardiovascular risk factors in South Africans of African ancestry with HIV was therefore studied. This cross-sectional study recruited 146 HIV-positive individuals on ART (HIV(+)ART(+)), 163 HIV-positive individuals not on ART (HIV(+)ART(-)) and 171 individuals without HIV (HIV-) in Mthatha, Eastern Cape Province of South Africa. Flow-mediated dilation (FMD) test was performed to assess endothelial function. Anthropometry and blood pressure parameters were measured. Lipid profile, glycaemic indices, serum creatinine as well as CD4 count and viral load were assayed in blood. Urinary albumin to creatinine ratio (ACR) was determined as a marker of cardiovascular risk. Obesity and albuminuria were positively associated with HIV, and HIV(+)ART(+) participants had significantly higher HDL cholesterol. Dyslipidaemia markers were significantly higher in hypertensive HIV(+)ART(+) participants compared with the controls (HIV(+)ART(-) and HIV- participants). FMD was not different between HIV(+)ART(+) participants and the controls. Moreover, HIV(+)ART(+) participants with higher FMD showed lower total cholesterol and LDL cholesterol comparable to that of HIV- and HIV(+)ART(-) participants. A positive relationship between FMD and CD4 count was observed in HIV(+)ART(+) participants. In conclusion, antiretroviral treatment was associated with cardiovascular risk factors, particularly dyslipidaemia, in hypertensive South Africans of African ancestry with HIV. Although, ART was not associated with endothelial dysfunction, flow-mediated dilatation was positively associated with CD4 count in HIV-positive participants on ART. ; The EndoAfrica-WSU study formed part of a broader consortium under the ERAfrica program of the European Union 7th Framework Program. Funding for this study was disbursed via the Department of Science and Innovation in South Africa (contract number DST/CON 0077/2014). PDB and NG received funding from the Belgian Science Policy in Belgium (grant number: BL/67/eranet03) and the Osterreichische Agentur fur internationale Mobilitat und Kooperation in Bildung, Wissenschaft und Forschung, OeAD GmbH (OAD) in Austria (grant number: KEF-Projekt P202), respectively. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. ; Goswami, N (corresponding author), Med Univ Graz, Otto Loewi Res Ctr Vasc Biol Immunol & Inflammat, Physiol Div, Neue Stiftingtalstr 6,D-5, A-8036 Graz, Austria. bnkehchungag@wsu.ac.za; nandu.goswami@medunigraz.at; gengwa@wsu.ac.za; crusike@wsu.ac.za; vuyombo@gmail.com; iwebster@sun.ac.za; Patrick.DeBoever@uantwerpen.be; harald.kessler@medunigraz.at; evelyn.stelzl@medunigraz.at; jgstr@sun.ac.za

Background People living with the Human Immunodeficiency Virus (PLHIV) have an increased susceptibility to develop non-communicable diseases such as cardiovascular disease (CVD). Infection with HIV contributes to the development of CVD independent of traditional risk factors, with endothelial dysfunction being the central physiological mechanism. While HIV-related mortality is declining due to antiretroviral treatment (ART), the number of deaths due to CVD is rising in South Africa - the country with the highest number of PLHIV and the world's largest ART programme. The EndoAfrica study was developed to determine whether HIV infection and ART are associated with cardiovascular risk markers and changes in vascular structure and function over 18 months in adults from different provinces of South Africa. This paper describes the rationale, methodology and baseline cohort profile of the EndoAfrica study conducted in the North West Province, South Africa. Methods In this case-control study, conducted between August 2017 and June 2018, 382 volunteers of African descent (276 women; 106 men), comprising of 278 HIV infected and 104 HIV free individuals were included. We measured health behaviours, a detailed cardiovascular profile, and performed biomarker analyses. We compared baseline characteristics, blood pressure, vascular function and biochemical markers between those infected and HIV free. Results At baseline, the HIV infected participants were older (43 vs 39 years), less were employed (21% vs 40%), less had a tertiary education (7% vs 16%) and their body mass index was lower (26 vs 29 kg/m(2)) than that of the HIV free participants. While the cardiovascular profile, flow-mediated dilation and pulse wave velocity did not differ, glycated haemoglobin was lower (p = 0.017) and total cholesterol, high density lipoprotein cholesterol, triglycerides, gamma-glutamyltransferase and tobacco use were higher (allp < 0.047) in PLHIV. Conclusion Despite PLHIV being older, preliminary cross-sectional analysis suggests that PLHIV being treated with ART do not have poorer endothelial or vascular function compared to the HIV free participants. More detailed analyses on the baseline and follow-up data will provide further clarity regarding the cardiovascular profile of South Africans living with HIV. ; The EndoAfrica-NWU study formed part of a broader consortium under the ERAfrica program of the European Union 7th Framework Program. Funding is disbursed via the Department of Science and Innovation in South Africa (contract number DST/CON 0077/2014). AES is funded by the South African National Research Foundation (SARChI GUN 86895) and South African Medical Research Council. PDB and NG received funding from the Belgian Science Policy in Belgium (Grant number BL/67/eranet03), and the Osterreichische Agentur fur internationale Mobilitat und Kooperation in Bildung, Wissenschaft und Forschung, OeAD GmbH (OAD) in Austria (Grant number: KEF-Projekt P202). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. ; Fourie, CMT (corresponding author), North West Univ, Hypertens Africa Res Team HART, Private Bag X1290, Potchefstroom, South Africa; North West Univ, Fac Hlth Sci, South African Med Res Council, Unit Hypertens & Cardiovasc Dis, Potchefstroom, South Africa. carla.fourie@nwu.ac.za