Distribution and Performance of Cardiovascular Risk Scores in a Mixed Population of HIV-Infected and Community-Based HIV-Uninfected Individuals in Uganda.

Autor:	Muiru AN; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA.; Currently, Division of Nephrology, Department of Medicine, University of California San Francisco, San Francisco, CA., Bibangambah P; Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda., Hemphill L; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA., Sentongo R; Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda., Kim JH; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Triant VA; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA., Bangsberg DR; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA.; Currently, Oregon Health Sciences University-Portland State University School of Public Health, Portland, OR., Tsai AC; Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.; Chester M. Pierce, MD, Division of Global Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA., Martin JN; Epidemiology and Biostatistics, University of California, San Francisco, CA., Haberer JE; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA., Boum Y 2nd; Epicentre Research Base, Mbarara, Uganda., Plutzky J; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Hunt PW; Epidemiology and Biostatistics, University of California, San Francisco, CA., Okello S; Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda., Siedner MJ; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA.; Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
Jazyk:	angličtina
Zdroj:	Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2018 Aug 01; Vol. 78 (4), pp. 458-464.
DOI:	10.1097/QAI.0000000000001696
Abstrakt:	Background: The utility and validity of cardiovascular diseases (CVD) risk scores are not well studied in sub-Saharan Africa. We compared and correlated CVD risk scores with carotid intima media thickness (c-IMT) among HIV-infected and uninfected people in Uganda. Methods: We first calculated CVD risk using the (1) Framingham laboratory-based score; (2) Framingham nonlaboratory score (FRS-BMI); (3) Reynolds risk score; (4) American College of Cardiology and American Heart Association score; and (5) the Data collection on Adverse Effects of Anti-HIV Drugs score. We then compared absolute risk scores and risk categories across each score using Pearson correlation and kappa statistics, respectively. Finally, we fit linear regression models to estimate the strength of association between each risk score and c-IMT. Results: Of 205 participants, half were females and median age was 49 years [interquartile range (IQR) 46-53]. Median CD4 count was 430 cells/mm (IQR 334-546), with median 7 years of antiretroviral therapy exposure (IQR 6.4-7.5). HIV-uninfected participants had a higher median systolic blood pressure (121 vs. 110 mm Hg), prevalent current smokers (18% vs. 4%, P = 0.001), higher median CVD risk scores (P < 0.003), and greater c-IMT (0.68 vs. 0.63, P = 0.003). Overall, FRS-BMI was highly correlated with other risk scores (all rho >0.80). In linear regression models, we found significant correlations between increasing CVD risk and higher c-IMT (P < 0.01 in all models). Conclusions: In this cross-sectional study from Uganda, the FRS-BMI correlated well with standard risk scores and c-IMT. HIV-uninfected individuals had higher risk scores than HIV-infected individuals, and the difference seemed to be driven by modifiable factors.
Databáze:	MEDLINE
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