Nominated From: University of Washington
Research Site: Peru
Research Area: Infectious Disease
Primary Mentor: Jaime Soria
Association of cardiovascular risk factors and metabolic syndrome in a Peruvian cohort of naïve HIV patients that start HAART
Peru, a developing country, has a 0.4% prevalence of human immunodeficiency virus (HIV) infection (1). Lima, the capital, is the city that has reported 63% of all HIV cases between the last 20 years, with a cumulative incidence of 4.01 per 100,000 inhabitants. (2)
The development of highly active antiretroviral therapy (HAART) has achieved an increase in the life expectancy of patients with HIV. This change is reflected in the reduction of deaths associated to opportunistic infections, among others. The mortality rate has descended from 3.79/100 person-years in 1996 to 0.32/100 person-years in 2004. (3)
However, the development of non-communicable diseases is becoming increasingly common, particularly cardiovascular disease (CVD). Recent studies indicate that at least 8% of the causes of hospitalization and 15% of the causes of death in these patients is CVD associated. (3, 4) Furthermore, the risk of having a heart attack is 50% more likely in patients with HIV. (5)
The reported prevalence of metabolic syndrome in HIV patients receiving HAART is 18%. (6) In Latino populations the prevalence is 20.2% and principal associated factors are: dyslipidemia and high blood pressure. (7) This dyslipidemia is characterized by hypertriglyceridemia and decreased HDL cholesterol, especially in schemes with at least one protease inhibitor drug (IP). (8)
Metalobic síndrome is considered as a cardiovascular risk enhancer (9) and in Latino patients, specific risk groups have been identified: female patients. (7) However, we have not found prospective studies that allow a better analysis of this risk factors. Preliminary results of a cross-sectional study performed at Hospital Nacional Dos de Mayo reports 37% of dyslipidemia in HIV patients. (Rondán et al. preliminary results).
Recent reports suggest to evaluate the lipid profile before the medication of HAART, to asses the presence of dyslipidemia. Periodic controls between the first months are also suggested. (10,11). Therefore, the present study aims to evaluate the association of cardiovascular risk factors that follow the development of metabolic syndrome in a Peruvian cohort of naïve patients with VIH infection that start HAART.
- Jaime Soria, Universidad Nacional Mayor de San Marcos
- Eduardo Ticona, Universidad Nacional Mayor de San Marcos