Coronary Heart Disease (CHD) Risk Factors and Metabolic Syndrome in HIV-Positive Drug Users in Miami

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dc.contributor.authorBaum, Marianna K.en
dc.contributor.authorRafie, Carlinen
dc.contributor.authorLai, Shenghanen
dc.contributor.authorXue, Lihuaen
dc.contributor.authorSales, Sabrinaen
dc.contributor.authorPage, J. Bryanen
dc.contributor.authorBerkman, Ronalden
dc.contributor.authorKaras, Lindenen
dc.contributor.authorCampa, Adrianaen
dc.coverage.cityMiamien
dc.coverage.countryUnited Statesen
dc.coverage.stateFloridaen
dc.date.accessioned2022-01-26T16:09:30Zen
dc.date.available2022-01-26T16:09:30Zen
dc.date.issued2006-01en
dc.date.updated2022-01-26T16:09:29Zen
dc.description.abstractThe frequency of coronary heart disease (CHD) is increasing among HIV seropositive persons. This phenomenon may be related to HIV disease itself, the use of antiretroviral medications and increased length of survival, or the synergism of these factors. In this study we have calculated the 10-year CHD risk estimate and the prevalence of metabolic syndrome in a cohort of 118 HIV seropositive chronic drug users, including those who are on HAART with or without protease inhibitors (PI). The results showed that the 10-year coronary heart disease risk among the HIV seropositive drug users was 4.8 ± 5.7, which is within the range of results published for other HIV infected cohorts. The 10-year CHD risk was significantly higher in men (5.9±6.1, p<0.001) than in women (1.7±2.4), due to their gender and the pre-menopausal mean age of the women (39.4±7.3 years of age), despite a significantly higher rate of abdominal obesity (54.8% in women vs. 8.1% in men, p<0.001) and lower HDL (61.3% in women vs. 40% in men, p=0.042). The rate of metabolic syndrome among our female HIV seropositive drug users was significantly higher (29% vs 10.3%, p=0.013) compared to men (10.3%). Participants with metabolic syndrome had a significantly higher 10-year CHD risk (27.8% vs. 10.2%, p=0.041) and higher mean BMI (28.6 ± 4.1 vs. 24.2±4, p<0.001) than those without the syndrome. The predominant proportion of the cohort had a high viral load, suggesting that their use of illicit drugs has an influence on either adherence or effectiveness of antiretroviral medication. Increased viral load was significantly associated with metabolic syndrome (OR=2.23, 95% CI:1.12, 4.47; p=0.023), high fasting glucose (OR=1.61, 95% CI: 1.02, 2.55; p=0.042) and low HDL levels (OR=1.41, 95% CI: 1.01, 1.98; p=0.046), after controlling for age gender, smoking, PI exposure, BMI and CD4. HAART with or without PI did not significantly impact the 10-year CHD risk estimate or metabolic syndrome in this cohort. The estimated effect of PI, however, was positively and significantly related to triglyceride levels (effect estimate=95.81; 95% CI:39.40, 152.21; p<0.01) after controlling for age, gender, smoking, viral load, CD4 cell count and BMI. Heavy use of cigarettes and crack/cocaine was inversely associated with obesity (OR=0.84, 95% CI:0.67, 0.99; p=0.049; OR=0.43, 95% CI:0.19, 0.98; p=0.044, respectively), while use of marijuana tended to be associated with increased central obesity (p=0.08). Heavy cigarette smoking was significantly associated with low HDL (OR=3.06, 95% CI:1.18; 7.95, p=0.02). The significant association of higher viral load with CHD risk indicates that controlling viral load may be important in reducing CHD risk in HIV infected drug users.en
dc.description.versionAccepted versionen
dc.format.extentPages 173-179en
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.3844/ajidsp.2006.173.179en
dc.identifier.issn1553-6203en
dc.identifier.issue3en
dc.identifier.orcidRafie, Carlin [0000-0002-1402-5650]en
dc.identifier.otherPMC2435190en
dc.identifier.pmid18568100en
dc.identifier.urihttp://hdl.handle.net/10919/107935en
dc.identifier.volume2en
dc.language.isoenen
dc.publisherScience Publicationsen
dc.relation.urihttps://www.ncbi.nlm.nih.gov/pubmed/18568100en
dc.rightsIn Copyrighten
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/en
dc.subject1117 Public Health and Health Servicesen
dc.titleCoronary Heart Disease (CHD) Risk Factors and Metabolic Syndrome in HIV-Positive Drug Users in Miamien
dc.title.serialAmerican Journal of Infectious Diseasesen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.otherresearch-articleen
dc.type.otherJournal Articleen
pubs.organisational-group/Virginia Techen
pubs.organisational-group/Virginia Tech/Agriculture & Life Sciencesen
pubs.organisational-group/Virginia Tech/Agriculture & Life Sciences/Human Nutrition, Foods, & Exerciseen

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