TY - JOUR
T1 - The effect of HIV infection, antiretroviral therapy on carotid intima-media thickness: A systematic review and meta-analysis
AU - Msoka, Titus F.
AU - van Guilder, Gary P.
AU - van Furth, Marceline
AU - Smulders, Yvo
AU - Meek, Sebastian J.
AU - Bartlett, John A.
AU - Vissoci, Joao Ricardo N.
AU - van Agtmael, Michiel A.
N1 - Funding Information: The NUFFIC Scholarship programme, The Netherlands, and an International Fellows Program award from the University of Wisconsin System supported this study. JB receives salary support from the US National Institutes of Health Awards P30AI64518 , U01AI067854 , D43CA153722 , and D43TW06732 , and from the Health Resources and Services Administration Award T84HA21123 . All authors designed the study, contributed and revised manuscript drafts, and approved the final manuscript. MVA, MVF, TF and JB supervised data collection procedures, patient recruitment, and human subject protection. TF and GV performed data collection procedures and developed the dataset. All authors completed the review of literature, data analysis, and prepared text. Appendix A Publisher Copyright: © 2019 Elsevier Inc. Copyright: Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/10/15
Y1 - 2019/10/15
N2 - Aims: We performed a systematic review and meta-analysis on the effect of HIV infection and antiretroviral therapy (ART) on carotid intima-media thickness (cIMT) to elucidate the role of HIV infection and ART. Also, an analysis on the role of ethnicity and gender on cIMT in HIV-infected populations was performed. Main methods: We searched the PubMed, Web of Science, the WHO websites and International AIDS Society for published observational studies were conducted by two independent reviewers for studies comparing HIV-infected antiretroviral-experienced patients and/or inexperienced with healthy controls on cIMT. The primary outcome was the standardized mean difference (SMD) of cIMT. Findings: Twenty studies (five cohort, 15 cross-sectional, and two both cohort and cross-sectional studies) were identified comprising 7948 subjects (4656 HIV-infected; 3292 controls). In cohort studies, the standardized mean 1-year change in cIMT between HIV-infected patients and uninfected controls was not significantly different (0.16 mm/yr; 95% CI, −0.16, 0.49; p = 0.326). In 17 cross-sectional studies, the SMD in cIMT was significantly higher in HIV-infected than uninfected persons (0.27 mm; 95% CI, 0.04, 0.49; p = 0.027). HIV-infected patients on ART exhibited significantly higher SMD in cIMT compared to those not on ART (0.75 mm; 95% CI, 0.30, 1.19; p = 0.001). No confounding effect of gender and ethnicity could be established using meta-regression p > 0.05. Significance: HIV infection itself and ART appear to influence the progression of cIMT and hence may be risk factors for cardiovascular events. No firm conclusions could be drawn on the effect of ethnic/race and gender differences on cIMT in HIV-infected populations.
AB - Aims: We performed a systematic review and meta-analysis on the effect of HIV infection and antiretroviral therapy (ART) on carotid intima-media thickness (cIMT) to elucidate the role of HIV infection and ART. Also, an analysis on the role of ethnicity and gender on cIMT in HIV-infected populations was performed. Main methods: We searched the PubMed, Web of Science, the WHO websites and International AIDS Society for published observational studies were conducted by two independent reviewers for studies comparing HIV-infected antiretroviral-experienced patients and/or inexperienced with healthy controls on cIMT. The primary outcome was the standardized mean difference (SMD) of cIMT. Findings: Twenty studies (five cohort, 15 cross-sectional, and two both cohort and cross-sectional studies) were identified comprising 7948 subjects (4656 HIV-infected; 3292 controls). In cohort studies, the standardized mean 1-year change in cIMT between HIV-infected patients and uninfected controls was not significantly different (0.16 mm/yr; 95% CI, −0.16, 0.49; p = 0.326). In 17 cross-sectional studies, the SMD in cIMT was significantly higher in HIV-infected than uninfected persons (0.27 mm; 95% CI, 0.04, 0.49; p = 0.027). HIV-infected patients on ART exhibited significantly higher SMD in cIMT compared to those not on ART (0.75 mm; 95% CI, 0.30, 1.19; p = 0.001). No confounding effect of gender and ethnicity could be established using meta-regression p > 0.05. Significance: HIV infection itself and ART appear to influence the progression of cIMT and hence may be risk factors for cardiovascular events. No firm conclusions could be drawn on the effect of ethnic/race and gender differences on cIMT in HIV-infected populations.
KW - Antiretroviral therapy (ART)
KW - Carotid intima-media thickness (cIMT)
KW - Ethnicity
KW - Gender
KW - Human-immunodeficiency virus (HIV)
UR - http://www.scopus.com/inward/record.url?scp=85071972530&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.lfs.2019.116851
DO - https://doi.org/10.1016/j.lfs.2019.116851
M3 - Review article
C2 - 31499070
SN - 0024-3205
VL - 235
JO - Life sciences
JF - Life sciences
M1 - 116851
ER -