The effect of HIV infection, antiretroviral therapy on carotid intima-media thickness: A systematic review and meta-analysis

Titus F. Msoka, Gary P. van Guilder, Marceline van Furth, Yvo Smulders, Sebastian J. Meek, John A. Bartlett, Joao Ricardo N. Vissoci, Michiel A. van Agtmael

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

Aims: We performed a systematic review and meta-analysis on the effect of HIV infection and antiretroviral therapy (ART) on carotid intima-media thickness (cIMT) to elucidate the role of HIV infection and ART. Also, an analysis on the role of ethnicity and gender on cIMT in HIV-infected populations was performed. Main methods: We searched the PubMed, Web of Science, the WHO websites and International AIDS Society for published observational studies were conducted by two independent reviewers for studies comparing HIV-infected antiretroviral-experienced patients and/or inexperienced with healthy controls on cIMT. The primary outcome was the standardized mean difference (SMD) of cIMT. Findings: Twenty studies (five cohort, 15 cross-sectional, and two both cohort and cross-sectional studies) were identified comprising 7948 subjects (4656 HIV-infected; 3292 controls). In cohort studies, the standardized mean 1-year change in cIMT between HIV-infected patients and uninfected controls was not significantly different (0.16 mm/yr; 95% CI, −0.16, 0.49; p = 0.326). In 17 cross-sectional studies, the SMD in cIMT was significantly higher in HIV-infected than uninfected persons (0.27 mm; 95% CI, 0.04, 0.49; p = 0.027). HIV-infected patients on ART exhibited significantly higher SMD in cIMT compared to those not on ART (0.75 mm; 95% CI, 0.30, 1.19; p = 0.001). No confounding effect of gender and ethnicity could be established using meta-regression p > 0.05. Significance: HIV infection itself and ART appear to influence the progression of cIMT and hence may be risk factors for cardiovascular events. No firm conclusions could be drawn on the effect of ethnic/race and gender differences on cIMT in HIV-infected populations.
Original languageEnglish
Article number116851
JournalLife Sciences
Volume235
DOIs
Publication statusPublished - 2019

Cite this

@article{7e78b9c53b674d399eef7d34f71036d7,
title = "The effect of HIV infection, antiretroviral therapy on carotid intima-media thickness: A systematic review and meta-analysis",
abstract = "Aims: We performed a systematic review and meta-analysis on the effect of HIV infection and antiretroviral therapy (ART) on carotid intima-media thickness (cIMT) to elucidate the role of HIV infection and ART. Also, an analysis on the role of ethnicity and gender on cIMT in HIV-infected populations was performed. Main methods: We searched the PubMed, Web of Science, the WHO websites and International AIDS Society for published observational studies were conducted by two independent reviewers for studies comparing HIV-infected antiretroviral-experienced patients and/or inexperienced with healthy controls on cIMT. The primary outcome was the standardized mean difference (SMD) of cIMT. Findings: Twenty studies (five cohort, 15 cross-sectional, and two both cohort and cross-sectional studies) were identified comprising 7948 subjects (4656 HIV-infected; 3292 controls). In cohort studies, the standardized mean 1-year change in cIMT between HIV-infected patients and uninfected controls was not significantly different (0.16 mm/yr; 95{\%} CI, −0.16, 0.49; p = 0.326). In 17 cross-sectional studies, the SMD in cIMT was significantly higher in HIV-infected than uninfected persons (0.27 mm; 95{\%} CI, 0.04, 0.49; p = 0.027). HIV-infected patients on ART exhibited significantly higher SMD in cIMT compared to those not on ART (0.75 mm; 95{\%} CI, 0.30, 1.19; p = 0.001). No confounding effect of gender and ethnicity could be established using meta-regression p > 0.05. Significance: HIV infection itself and ART appear to influence the progression of cIMT and hence may be risk factors for cardiovascular events. No firm conclusions could be drawn on the effect of ethnic/race and gender differences on cIMT in HIV-infected populations.",
author = "Msoka, {Titus F.} and {van Guilder}, {Gary P.} and {van Furth}, Marceline and Yvo Smulders and Meek, {Sebastian J.} and Bartlett, {John A.} and Vissoci, {Joao Ricardo N.} and {van Agtmael}, {Michiel A.}",
year = "2019",
doi = "10.1016/j.lfs.2019.116851",
language = "English",
volume = "235",
journal = "Life Sciences",
issn = "0024-3205",
publisher = "Elsevier Inc.",

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The effect of HIV infection, antiretroviral therapy on carotid intima-media thickness: A systematic review and meta-analysis. / Msoka, Titus F.; van Guilder, Gary P.; van Furth, Marceline; Smulders, Yvo; Meek, Sebastian J.; Bartlett, John A.; Vissoci, Joao Ricardo N.; van Agtmael, Michiel A.

In: Life Sciences, Vol. 235, 116851, 2019.

Research output: Contribution to journalReview articleAcademicpeer-review

TY - JOUR

T1 - The effect of HIV infection, antiretroviral therapy on carotid intima-media thickness: A systematic review and meta-analysis

AU - Msoka, Titus F.

AU - van Guilder, Gary P.

AU - van Furth, Marceline

AU - Smulders, Yvo

AU - Meek, Sebastian J.

AU - Bartlett, John A.

AU - Vissoci, Joao Ricardo N.

AU - van Agtmael, Michiel A.

PY - 2019

Y1 - 2019

N2 - Aims: We performed a systematic review and meta-analysis on the effect of HIV infection and antiretroviral therapy (ART) on carotid intima-media thickness (cIMT) to elucidate the role of HIV infection and ART. Also, an analysis on the role of ethnicity and gender on cIMT in HIV-infected populations was performed. Main methods: We searched the PubMed, Web of Science, the WHO websites and International AIDS Society for published observational studies were conducted by two independent reviewers for studies comparing HIV-infected antiretroviral-experienced patients and/or inexperienced with healthy controls on cIMT. The primary outcome was the standardized mean difference (SMD) of cIMT. Findings: Twenty studies (five cohort, 15 cross-sectional, and two both cohort and cross-sectional studies) were identified comprising 7948 subjects (4656 HIV-infected; 3292 controls). In cohort studies, the standardized mean 1-year change in cIMT between HIV-infected patients and uninfected controls was not significantly different (0.16 mm/yr; 95% CI, −0.16, 0.49; p = 0.326). In 17 cross-sectional studies, the SMD in cIMT was significantly higher in HIV-infected than uninfected persons (0.27 mm; 95% CI, 0.04, 0.49; p = 0.027). HIV-infected patients on ART exhibited significantly higher SMD in cIMT compared to those not on ART (0.75 mm; 95% CI, 0.30, 1.19; p = 0.001). No confounding effect of gender and ethnicity could be established using meta-regression p > 0.05. Significance: HIV infection itself and ART appear to influence the progression of cIMT and hence may be risk factors for cardiovascular events. No firm conclusions could be drawn on the effect of ethnic/race and gender differences on cIMT in HIV-infected populations.

AB - Aims: We performed a systematic review and meta-analysis on the effect of HIV infection and antiretroviral therapy (ART) on carotid intima-media thickness (cIMT) to elucidate the role of HIV infection and ART. Also, an analysis on the role of ethnicity and gender on cIMT in HIV-infected populations was performed. Main methods: We searched the PubMed, Web of Science, the WHO websites and International AIDS Society for published observational studies were conducted by two independent reviewers for studies comparing HIV-infected antiretroviral-experienced patients and/or inexperienced with healthy controls on cIMT. The primary outcome was the standardized mean difference (SMD) of cIMT. Findings: Twenty studies (five cohort, 15 cross-sectional, and two both cohort and cross-sectional studies) were identified comprising 7948 subjects (4656 HIV-infected; 3292 controls). In cohort studies, the standardized mean 1-year change in cIMT between HIV-infected patients and uninfected controls was not significantly different (0.16 mm/yr; 95% CI, −0.16, 0.49; p = 0.326). In 17 cross-sectional studies, the SMD in cIMT was significantly higher in HIV-infected than uninfected persons (0.27 mm; 95% CI, 0.04, 0.49; p = 0.027). HIV-infected patients on ART exhibited significantly higher SMD in cIMT compared to those not on ART (0.75 mm; 95% CI, 0.30, 1.19; p = 0.001). No confounding effect of gender and ethnicity could be established using meta-regression p > 0.05. Significance: HIV infection itself and ART appear to influence the progression of cIMT and hence may be risk factors for cardiovascular events. No firm conclusions could be drawn on the effect of ethnic/race and gender differences on cIMT in HIV-infected populations.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85071972530&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/31499070

U2 - 10.1016/j.lfs.2019.116851

DO - 10.1016/j.lfs.2019.116851

M3 - Review article

VL - 235

JO - Life Sciences

JF - Life Sciences

SN - 0024-3205

M1 - 116851

ER -