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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/23286

Title: Cardiovascular risk and endothelial function in people living with HIV/AIDS: design of the multi-site, longitudinal EndoAfrica study in the Western Cape Province of South Africa
Authors: Strijdom, Hans
De Boever, Patrick
Walzl, Gerhard
Essop, M. Faadiel
Nawrot, Tim S.
Webster, Ingrid
Westcott, Corli
Mashele, Nyiko
Everson, Frans
Malherbe, Stephanus T.
Stanley, Kim
Kessler, Harald H.
Stelzl, Evelyn
Goswami, Nandu
Issue Date: 2017
Citation: BMC INFECTIOUS DISEASES, 17 (Art N° 41)
Abstract: Background: There is growing evidence of an interaction between HIV-infection, anti-retroviral therapy (ART) and cardiovascular diseases (CVD). Epidemiological studies in Europe and North America have been observing a shift towards an increased incidence of coronary heart disease and acute myocardial infarctions in HIV-infected populations compared to the general population even after adjusting for traditional cardiovascular risk factors. Despite South Africa (and sub-Saharan Africa, SSA) being regarded as the epicentre of the global HIV epidemic, very little is known about the prevalence of cardiovascular risk factors and precursors of vascular disease in HIV-infected populations in this region. The knowledge gap is further widened by the paucity of data from prospective studies. We present the rationale, objectives and key methodological features of the EndoAfrica study, which aims to determine whether HIV-infection and ART are associated with altered cardiovascular risk and changes in vascular endothelial structure and function in adults living in the Western Cape Province of South Africa. Methods: In this longitudinal study, comprehensive cardiovascular assessments of HIV-negative and HIV-positive (with and without ART) study participants are performed by clinical and biochemical screening for traditional cardiovascular risk factors and biomarkers of CVD. Vascular and endothelial function is determined by brachial artery flow-mediated dilatation (FMD), carotid-intima-thickness (IMT) measurements and quantitative retinal blood vessel analyses, complemented by vascular endothelial biomarker assays. Finally, we aim to statistically determine whether HIV-infection and/or ART are associated with increased cardiovascular risk and vascular endothelial dysfunction, and determine whether there is progression/regression in these endpoints 18 months after the baseline assessments. Discussion: The EndoAfrica study provides a unique opportunity to recruit a cohort of HIV-infected patients and HIV-negative controls who will be comprehensively and longitudinally assessed for cardiovascular risk and disease profile with vascular endothelial function as a potentially important intermediate cardiovascular phenotype. To our knowledge, it is the first time that such a systematic study has been established in the context of SSA and South Africa.
Notes: [Strijdom, Hans; Webster, Ingrid; Westcott, Corli; Mashele, Nyiko; Everson, Frans] Univ Stellenbosch, Fac Med & Hlth Sci, Div Med Physiol, POB 241, ZA-8000 Cape Town, South Africa. [De Boever, Patrick] Flemish Inst Technol Res VITO, Environm Risk & Hlth Unit, Boeretang 200, B-2400 Mol, Belgium. [De Boever, Patrick; Nawrot, Tim S.] Hasselt Univ, Ctr Environm Studies, Agoralaan, B-3590 Diepenbeek, Belgium. [Walzl, Gerhard; Malherbe, Stephanus T.; Stanley, Kim] Univ Stellenbosch, Div Human Genet & Mol Biol, DST NRF Ctr Excellence Biomed TB Res, Fac Med & Hlth Sci, POB 241, ZA-8000 Cape Town, South Africa. [Walzl, Gerhard; Malherbe, Stephanus T.; Stanley, Kim] Univ Stellenbosch, SAMRC Ctr TB Res, Fac Med & Hlth Sci, POB 241, ZA-8000 Cape Town, South Africa. [Essop, M. Faadiel] Univ Stellenbosch, Cardiometab Res Grp CMRG, Dept Physiol Sci, Fac Sci, ZA-7600 Stellenbosch, South Africa. [Nawrot, Tim S.] Leuven Univ, Dept Publ Hlth & Primary Care, Kapucijnenvoer 35, B-3000 Leuven, Belgium. [Kessler, Harald H.; Stelzl, Evelyn] Med Univ Graz, Inst Hyg Microbiol & Environm Med, Univ Pl 4, A-8010 Graz, Austria. [Goswami, Nandu] Med Univ Graz, Gravitat Physiol & Med Res Unit, Inst Physiol, Harrachgasse 21-5, A-8010 Graz, Austria.
URI: http://hdl.handle.net/1942/23286
DOI: 10.1186/s12879-016-2158-y
ISI #: 000391327100003
ISSN: 1471-2334
Category: A1
Type: Journal Contribution
Appears in Collections: Research publications

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