Lipodystrophy and serum lipid abnormalities in HIV-positive sub-Saharan population on ART

Dietary studies have been carried out on the effects of ingested carbohydrate and fat (as MCT and LCT) on hyperlipemia in a patient with von Gierke's disease. Increased carbohydrate in the diet resulted in increased serum lipid levels represented predominantly in the triglyceride fraction. Substitution of MCT for LCT in the diet when carbohydrate consumption was at normal levels resulted in significantly decreased serum lipid levels, disappearance of eruptive xanthomas, and reduction in liver size. We suggest on the basis of this preliminary study that excess carbohydrate should be avoided in the diet and substitution of MCT for LCT should be considered as a rational approach to management of lipid abnormalities in von Gierke's disease.

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HIV is associated with endothelial activation despite ART, in a sub-Saharan African setting

Neurology Neuroimmunology & Neuroinflammation ◽

10.1212/nxi.0000000000000531 ◽

2018 ◽

Vol 6 (2) ◽

pp. e531 ◽

Cited By ~ 11

Author(s):

Joseph Kamtchum-Tatuene ◽

Henry Mwandumba ◽

Zaid Al-Bayati ◽

Janet Flatley ◽

Michael Griffiths ◽

...

Keyword(s):

Hiv Infection ◽

Endothelial Activation ◽

Sub Saharan Africa ◽

Intercellular Adhesion Molecule ◽

Hiv Positive ◽

Plasminogen Activator Inhibitor 1 ◽

Multivariable Logistic Regression Model ◽

Cross Sectional ◽

Sub Saharan ◽

Pai 1

ObjectiveTo study the relationship between endothelial dysfunction, HIV infection, and stroke in Malawians.MethodsUsing a cross-sectional design, we measured plasma levels of intercellular adhesion molecule-1 (ICAM-1), plasminogen activator inhibitor-1 (PAI-1), vascular endothelial growth factor (VEGF), and soluble thrombomodulin (sTM) in stroke patients and controls, stratified by HIV status. These biomarkers were measured using ELISA. After dichotomization, each biomarker was used as the dependent variable in a multivariable logistic regression model. Primary independent variables included HIV and stroke status. Adjustment variables were age, sex, hypertension, diabetes mellitus, tobacco and alcohol consumption, personal/family history of stroke, antiretroviral therapy status, and hypercholesterolemia.ResultsSixty-one stroke cases (19 HIV+) and 168 controls (32 HIV+) were enrolled. The median age was 55 years (38.5–65.0) for controls and 52 years (38.0–73.0) for cases (p = 0.38). The median CD4+ T-cell count was 260.1 cells/mm3 (156.3–363.9) and 452 cells/mm3 (378.1–527.4) in HIV-infected cases and controls, respectively. HIV infection was independently associated with high levels of ICAM-1 (OR = 3.6, 95% CI: 1.3–10.6, p = 0.018) in controls but not in stroke cases even after excluding patients with a viral load >1,000 RNA copies/mL (OR = 4.1, 95% CI: 1.3–13.1, p = 0.017). There was no association between the clinical profiles of HIV-positive controls or HIV-positive stroke and high levels of PAI-1, VEGF, and sTM.ConclusionsHIV infection is associated with endothelial activation despite antiretroviral treatment. Our findings underscore the need for larger clinical cohorts to better understand the contribution of this perturbation of the endothelial function to the increasing burden of cardiovascular diseases in sub-Saharan Africa.

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Mapping evidence on adolescents’ HIV-positive status disclosure in sub-Saharan Africa: a protocol for a scoping review

Systematic Reviews ◽

10.1186/s13643-020-01546-9 ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Patience Adzordor ◽

Clement Avoka ◽

Vitalis Bawontuo ◽

Silas Agbesi ◽

Desmond Kuupiel

Keyword(s):

Hiv Infection ◽

Scoping Review ◽

Keyword Search ◽

Sub Saharan Africa ◽

Hiv Positive ◽

People Living With Hiv ◽

Sub Saharan ◽

Living With Hiv ◽

Status Disclosure ◽

Hiv Aids

Abstract Background Sub-Saharan Africa (SSA) homes most of the people living with HIV/AIDS in the world. Adolescents/young people are a vulnerable population and at high risk of HIV infection. Identifying and bridging the research gaps on the disclosure of HIV-positive status among adolescents, particularly to their sexual partners, is essential to inform appropriate policy planning and implementation towards preventing HIV transmission. This study will aim to explore literature and describe the evidence on HIV-positive status disclosure among adolescents in SSA. Methods The framework provided by Arksey and O’Malley’s framework and improved by Levac and colleagues will be used to conduct a scoping review. A keyword search for relevant literature presenting evidence on HIV-positive status disclosure among adolescents in SSA will be conducted in CINAHL, PubMed, Science Direct, Google Scholar, and SCOPUS. Date limitations will be removed, but Boolean terms “AND” and “OR” as well as Medical Subject Headings terms will be included where possible and syntax modified to suit the database during the search. Additional relevant articles will be sought from the reference lists of all included studies using a snowballing method. Two reviewers will independently screen the articles at the abstract and full-text screening phases in order to reduce bias and improve the reliability of this study’s findings. A tabular form will be developed using Microsoft Word and piloted for data extraction. Thematic content analysis will be conducted, and a narrative summary of all relevant outcomes reported. Quality appraisal of the included studies for this proposed study will be performed utilizing the recent mixed methods appraisal tool. Discussion The evidence produced by this review may help inform policy and strategies to reduce the incidence of HIV infection among adolescents and improve social support for adolescents living with HIV/AIDS in SSA. It may also reveal literature gaps to guide future researches to further inform HIV policies for adolescents in SSA. Platforms such as peer review journals, policy briefs, and conferences will be used to disseminate this study’s findings.

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