Highly active antiretroviral therapy dvc (HAART) plays a critical role in suppressing viral titers a

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Abstract Full-Text PDF Full-Text HTML Linked References Citations to this Article How to Cite this Article dvc ISRN Cardiology Volume 2011 (2011), Article ID 897908, 5 pages http://dx.doi.org/10.5402/2011/897908
Benjamin Longo-Mbenza , 1 Murielle Longokolo Mashi , 2 Michel Lelo Tshikwela , 3 Etienne Mokondjimobe , 4 Thierry Gombet , 4 Bertrand Ellenga-Mbolla , 4 Augustin Nge Okwe , 5 Nelly Kangola Kabangu , 5 and Simon Mbungu Fuele 5
1 Faculty of Health Sciences, Walter dvc Sisulu University, Mthatha 5117, South Africa 2 Department dvc of Internal Medicine, University of Kinshasa, Kinshasa, dvc Democratic Republic of Congo 3 Department of Radiology, Kinshasa University, Democratic Republic of Congo 4 University of Marien Ngouabi, dvc Brazzaville, Democratic Republic of Congo 5 Lomo Medical Cardiovascular Centre for Africa, Limete, dvc Kinshasa, Democratic Republic of Congo
Background and Purpose . It now appears clear that both HIV/AIDS and antiretroviral therapy (HAART) use are associated with higher risk of cardiovascular disease such as stroke. In this study, we evaluated the prevalence, the risk factors, and the cardiometabolic dvc comorbidities of stroke in HIV/AIDS Central African patients. Methods . This hospital-based cross-sectional study collected clinical, laboratory, and imaging data of black Central African heterosexual, intravenous drug nonuser, and HIV/AIDS patients. Results . There were 54 men and 62 women, with a female to male ratio of 1.2 : 1. All were defined by hypercoagulability and oxidative stress. Hemorrhagic stroke was reported in 1 patient, ischemic stroke in 17 patients, and all stroke subtypes in 18 patients (15%). Younger age <45 years ( = . 0 0 3 ) , autoimmunity dvc ( < . 0 0 0 1 ) , and metabolic syndrome defined by IDF criteria ( < . 0 0 0 1 ) were associated with ischemic stroke. Conclusions . Clustering of several cardiometabolic factors, autoimmunity, oxidative stress, and lifestyle changes may explain accelerated atherosclerosis and high risk of stroke in these young black Africans with HIV/AIDS. Prevention and intervention programs are needed. 1. Background
Highly active antiretroviral therapy dvc (HAART) plays a critical role in suppressing viral titers and increasing CD4 + lymphocyte counts, which translate to significant reduced morbidity and mortality among HIV patients [ 1 , 2 ]. It now appears clear that both HIV infection dvc itself dvc and HAART use are associated with higher risk of stroke and metabolic disorders [ 3 – 5 ].
The majority of Central African HIV-infected patients do not have access to drugs of the first line and are not systematically on HAART till now. It is not established whether the HIV infection itself [ 4 ], the progression from asymptomatic to symptomatic dvc HIV disease, aging, lifestyle changes, reduction of defining HIV disease infections and tumors, ARV exposure, and traditional and new cardiovascular risk factors directly cause stroke in Central African HIV-infected patients. In these Africans, severe hypertension, hyperuricemia, hyperglycemia, high levels of Dr. dimer and fibrinogen, smoking, dvc excessive alcohol intake, Helicobacter pylori dvc , bacterial pneumonia, age ≥ 60 years, pulse pressure ≥ 60 mmHg, low socioeconomic status (SES), and rainy season are the risk factors of stroke [ 5 – 8 ].
This cross-sectional study was carried out on HIV-infected patients managed at the Department of Internal Medicine of the Teaching Hospital of Kinshasa, DRC, over a period from 1st January 2004 through 30th May 2008. The Teaching Hospital of Kinshasa is 1500-bed public university hospital that serves a black urban population of 6 million people. The climate is tropical. The study protocol designed according to the Helsinki Declaration II was approved by the local ethics committee. 2.1. Data Collection
Anthropometry recorded weight, height, waist circumference (WC), hip circumference (HC) and body mass index (BMI = weight, kg/height, m²) using standard methods in participants with light clothes and without shoes as described elsewhere [ 6 ]. Blood pressure (BP) including systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (SBP-DBP) after the participant had rested for 10 minutes seated in a quiet room, was measured in the left arm with elbow flexed at heart level using an Omron HEM 705 electronic BP manometer (Omron Life Science Co. Ltd, Tokyo, Japan).
Laboratory investigations included haemoglobin, hematocrit, glucose, total chol