Association of prior tuberculosis with cardiovascular status in perinatally HIV-1-infected adolescents.

Autor:	Magodoro IM; Department of Medicine, University of Cape Town, Observatory 7925, Republic of South Africa itai.magodoro@uct.ac.za., Guerrero-Chalela CE; Fundación Cardioinfantil - Instituto de Cardiología, Bogota, Colombia., Carkeek E; Department of Pediatrics and Child Health, University of Cape Town, Rondebosch 7700, Western Cape, South Africa., Asafu-Agyei NA; Department of Pediatrics and Child Health, University of Cape Town, Rondebosch 7700, Western Cape, South Africa., Jele N; Department of Pediatrics and Child Health, University of Cape Town, Rondebosch 7700, Western Cape, South Africa., Frigati LJ; Department of Paediatrics and Child Health, Stellenbosch University, Tygerberg 7505, South Africa., Myer L; School of Public Health and Family Medicine, University of Cape Town, Observatory 7925, South Africa., Jao J; Department of Pediatrics, Division of Pediatric Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago 60611, IL, USA.; Department of Internal Medicine, Division of Adult Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago 60611, IL, USA., Ntsekhe M; Division of Cardiology, University of Cape Town, Observatory 7925, Republic of South Africa., Wilkinson KA; Department of Medicine, University of Cape Town, Observatory 7925, Republic of South Africa.; Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Unversity of Cape Town, Observatory 7925, Republic of South Africa.; The Francis Crick Institute, London NW1 1 AT, UK., Wilkinson RJ; Department of Medicine, University of Cape Town, Observatory 7925, Republic of South Africa.; Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Unversity of Cape Town, Observatory 7925, Republic of South Africa.; The Francis Crick Institute, London NW1 1 AT, UK.; Department of Infectious Diseases, Imperial College, London SW7 2AZ, UK., Zar H; Department of Pediatrics and Child Health, University of Cape Town, Rondebosch 7700, Western Cape, South Africa., Ntusi N; Department of Medicine, University of Cape Town, Observatory 7925, Republic of South Africa.; Extramural Unit of Noncommunicable and Infectious Diseases, South African Medical Research Council , Observatory 7925, Republic of South Africa.
Jazyk:	angličtina
Zdroj:	Open heart [Open Heart] 2024 Nov 14; Vol. 11 (2). Date of Electronic Publication: 2024 Nov 14.
DOI:	10.1136/openhrt-2024-002960
Abstrakt:	Background: Whether, and how, co-occurring HIV-1 infection (HIV) and tuberculosis (TB) impact cardiovascular status, especially in adolescents with perinatally acquired HIV (APHIV), have not been examined. We hypothesised that APHIV with previous TB disease have worse cardiac efficiency than APHIV without TB, which is mediated by increased inflammation and disordered cardiometabolism. Methods: APHIV in Cape Town, South Africa, completed 3T cardiovascular magnetic resonance examination and high sensitivity C reactive protein (hsCRP), fasting plasma glucose (FPG), low-density lipoprotein (LDL) and triglyceride measurement. Ventriculoarterial coupling (VAC) was estimated as the ratio of arterial elastance (Ea) to ventricular end-systolic elastance (Ees). Regression models were applied to estimate cross-sectional associations between Ea/Ees ratio and TB status, with decomposition of these associations into direct and mediated effects of hsCRP, FPG and dyslipidaemia, if any, attempted. Results: We enrolled 43 APHIV with prior TB and 23 without TB of mean (SD) age 15.0 (1.5) and 15.4 (1.7) years, respectively. Prior TB was associated with lower Ea/Ees ratio (0.59 (0.56 to 0.64)) than no TB (0.66 (0.62 to 0.70)), which corresponded to an adjusted mean difference -0.06 (-0.12 to 0.01) (p=0.048). However, previous TB was not associated with increased hsCRP, FPG, LDL or triglycerides nor were hsCRP, FPG, LDL and triglycerides associated with Ea/Ees ruling out their mediated effects in the association between TB and cardiac efficiency. Conclusions: Previous TB in APHIV is associated with comparatively reduced cardiac efficiency, related to altered VAC. The clinical significance of these findings requires further study, including a wider range of biomarkers of specific immune pathways. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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