Seemingly low heart disease risk in HIV-positive individuals in Zimbabwe

Danai Tavonga Zhou has investigated the risk of coronary heart disease among HIV-positive individuals in Zimbabwe. At the present time the risk seems to be quite low, but it could potentially increase in the future.


MAIN RESULTS:

  1. Few HIV-positive individuals in Harare, Zimbabwe have a high Framingham risk score for coronary heart disease.
  2. Inflammation burden is high among HIV-infected patients in Zimbabwe, whereas lipids and blood glucose are within normal ranges.
  3. The combination of urbanization and high prevalence of HIV in Zimbabwe could lead to increased risk of coronary heart disease in coming years.

THESIS DEFENCE:

Thesis: Coronary heart disease risk – A study of demographic, biochemical and genetic factors in HIV adult patients
Candidate: Danai Tavonga Zhou
Time: September 15, 2017 at 13:15
Place: Oslo University Hospital, Rikshospitalet B: Blue auditorium
Link to university website (in Norwegian)


SUMMARY:

HIV induces chronic inflammation, and the use of antiretroviral drugs can result in dyslipidemia and hyperglycemia. Thus, the risk of coronary heart disease is generally increased in HIV-positive patients.

(1) Only 1.4 % of HIV-infected patients in Harare, Zimbabwe are at high risk of coronary artery disease within 10 years, according to the Framingham risk calculator. Among the 215 included patients the average lipid and glucose values were within normal ranges.

(3/5) Over nine months follow-up there were significant changes in lipid concentrations and increased Framingham risk in patients on antiretroviral drugs. The total cholesterol/HDL cholesterol ratio decreased. Both total cholesterol and HDL cholesterol were higher in patients treated with antiretroviral drugs, but within normal ranges in both groups. 171 patients were included in these analyses.

(2) More than half of 97 included patients had elevated levels of high-sensitive C-reactive protein, suggesting high risk of coronary artery disease in spite of antiretroviral therapy. One fourth had levels indicating average risk.

(4) In a mini-review, Zhou and co-workers conclude that it is likely that the burden of coronary heart disease will increase in Zimbabwe in the future, both as a result of urbanization in the general population and a high HIV disease burden.


REFERENCES:

(1) Zhou, D. T., Kodogo, V., Chokuona, K. F. V., Gomo, E., Oektedalen, O., & Stray-Pedersen, B. (2015). Dyslipidemia and cardiovascular disease risk profiles of patients attending an HIV treatment clinic in Harare, ZimbabweHIV/AIDS (Auckland, NZ)7, 145.

(2) Zhou, D. T., Kodogo, V., Dzafitita, M., Øktedalen, O., Muswe, R., & Stray-Pedersen, B. (2015). Lipids and hsCRP as markers of coronary heart disease risk in HIV infected adultsIJSTR4(8), 252-257.

(3) Zhou, D. T., Nehumba, D., Oktedalen, O., Marange, P., Kodogo, V., Gomo, Z. A., Esterhuizen, T. M., & Stray-Pedersen, B. (2016). Changes in Lipid Profiles of HIVBiochemistry research international2016.

(4) Zhou, D. T., Oktedalen, O., Chisango, T., & Stray-Pedersen, B. (2016). HIV/AIDS and Coronary Heart Disease on a Collision Course? Review of ZimbabweAmerican Journal of Medical and Biological Research4(2), 26-32.

(5) Zhou, D. T., Oektedalen, O., Shawarira-Bote, S., & Stray-Pedersen, B. (2016). Changes in coronary heart disease risk profiles of HIV patients in Zimbabwe over 9 months: a follow-up studyHIV/AIDS (Auckland, NZ)8, 165.