The Impact of Regular Screening and Lifestyle Modification on Cardiovascular Disease Risk Factors in South African Women Living With HIV.

IF 2.9 3区 医学 Q3 IMMUNOLOGY
Sherika Hanley, Dhayendre Moodley, Mergan Naidoo, Sean S Brummel
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Abstract

Background: The Integration of cardiovascular disease SCreening and prevention in the HIV MAnagement plan for women of reproductive age study set out to determine the effectiveness of screening and lifestyle modification in modifying cardiovascular disease (CVD) risk factors in women living with HIV (WLHIV).

Methods: In this prospective, quasiexperimental, intervention study, WLHIV aged 18-<50 years were enrolled from 2 clinics (intervention [I-arm]) and (control arms [C-arm]) in Umlazi, South Africa, between November 2018 and May 2019. Women in the I-arm received lifestyle modification advice on diet, physical activity, alcohol use, and smoking cessation and underwent annual screening for CVD risk. The CVD risk factors were assessed through standardized questionnaires and clinical and laboratory procedures at baseline and at end of 3 years of follow-up. Prevalence of metabolic syndrome and other CVD indices were compared between arms at end-of-study (EOS).

Results: Total of 269 WLHIV (149 I-arm and 120 C-arm) with a mean ± SD age of 36 ± 1 years were included in the EOS analyses after 32 ± 2 months of follow-up. The metabolic syndrome prevalence at EOS was 16.8% (25/149) in the I-arm and 24% (24/120) in the C-arm (risk ratio 0.9; 95% CI: 0.5 to 1.1; P 0.86). Proportion of women with fasting blood glucose >5.6 mmol/L in the I-arm and C-arm were 2.7% (4/149) and 13.3% (16/120) respectively (risk ratio 0.2; 95% CI: 0.069 to 0.646; P < 0.01). High-density lipoprotein improved with the intervention arm from baseline to EOS (95% CI: -0.157 to -0.034; P < 0.05).

Conclusions: Although there was no significant difference in the prevalence of metabolic syndrome between study arms, we observed decreased blood glucose levels in the I-arm compared with the C-arm and improved high-density lipoprotein within the I-arm, following lifestyle modification and regular screening for CVD risk factors in WLHIV.

定期筛查和改变生活方式对感染艾滋病毒的南非妇女心血管疾病风险因素的影响。
研究背景ISCHeMiA研究旨在确定筛查和生活方式调整对改变女性艾滋病病毒感染者(WLHIV)心血管疾病风险因素的有效性:在这项前瞻性准实验干预研究中,年龄在 18 岁以下的女性艾滋病病毒感染者(WLHIV)参与了研究:经过 32+2 个月的随访,共有 269 名平均年龄为 36+1 岁的 WLHIV(149 名 I 型感染者和 120 名 C 型感染者)被纳入 EOS 分析。在 EOS 时,I 组的 MetS 患病率为 16.8%(25/149),C 组为 24%(24/120)(RR 0.9;95%CI 0.5-1.1;P 0.86)。空腹血糖>5.6mmol/L的女性比例在I型臂和C型臂中分别为2.7%(4/149)和13.3%(16/120)(RR 0.2;95%CI 0.069-0.646;p结论:虽然各研究组之间的 MetS 患病率没有明显差异,但我们观察到,与 C 组相比,I 组的血糖水平有所下降,而在 WLHIV 中,在改变生活方式并定期筛查心血管疾病风险因素后,I 组的高密度脂蛋白有所提高。
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来源期刊
CiteScore
5.80
自引率
5.60%
发文量
490
审稿时长
3-6 weeks
期刊介绍: JAIDS: Journal of Acquired Immune Deficiency Syndromes​ seeks to end the HIV epidemic by presenting important new science across all disciplines that advance our understanding of the biology, treatment and prevention of HIV infection worldwide. JAIDS: Journal of Acquired Immune Deficiency Syndromes is the trusted, interdisciplinary resource for HIV- and AIDS-related information with a strong focus on basic and translational science, clinical science, and epidemiology and prevention. Co-edited by the foremost leaders in clinical virology, molecular biology, and epidemiology, JAIDS publishes vital information on the advances in diagnosis and treatment of HIV infections, as well as the latest research in the development of therapeutics and vaccine approaches. This ground-breaking journal brings together rigorously peer-reviewed articles, reviews of current research, results of clinical trials, and epidemiologic reports from around the world.
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