Cardiovascular pathology detected during follow-up care of people living with HIV adherent to antiretroviral therapy

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Abstract

Objective. Evaluation of the role of follow-up care conducted in a medical organization specializing in providing assistance to people living with HIV (PLHIV), in identifying cardiovascular diseases (CVD) and stratifying CV risks.

Materials and methods. The age profile of CVDs detected by a general practitioner and a cardiologist was analyzed using the medical records of 400 PLHIV receiving foloow-up care at the Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being. The age discrimination ability for the detected nosologies was determined. The lipid profile of PLHIV adherent to modern antiretroviral therapy (ART) regimens was characterized, CV risks were calculated using the SCORE2 and SCORE2-OP scales, and the obtained data were compared with the general population data. The effect of a cardiologist consultation on adherence to antihypertensive and lipid-lowering therapy was studied.

Results. It was determined that the age profile of CVDs in PLHIV adherent to ART does not differ from that in the general population. At the same time, the addition of a cardiologist consultation to follow-up care increases the detection of CVD compared to a protocol that includes only examinations by a general practitioner. The lipid profile in PLHIV differs from the general population by higher concentrations of low-density lipoproteins and lower triglyceride levels. Taking a number of ART regimens is associated with abnormal concentrations of individual plasma lipid fractions. Patients who were consulted by a cardiologist had significantly higher adherence to antihypertensive and lipid-lowering therapy; such a relationship was not determined for consultations with a general practitioner.

Conclusion. The use of estimated cardiovascular risk scales by attending physician provides timely identification of indications for consultation with a cardiologist among PLHIV over 40 years of age. An infectious disease specialist can correct these risks taking into account the proatherogenic potential of ART. Individualization of screening for concomitant pathology of PLHIV allows for improving their quality of life and reducing treatment costs.

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About the authors

Andrey M. Shilov

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; Patrice Lumumba Peoples’ Friendship University of Russia

Author for correspondence.
Email: sh_andrey_max@mail.ru
ORCID iD: 0009-0000-7966-9708

Graduate student, Central Research Institute of Epidemiology, Assistent, Department of Infectious Diseases with Courses of Epidemiology and Phthisiology, Medical Institute

Russian Federation, Moscow; Moscow

Anastasia V. Pokrovskaya

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; Patrice Lumumba Peoples’ Friendship University of Russia

Email: pokrovskaya@cmd.su
ORCID iD: 0000-0002-2677-0404

MD, Senior Researcher, Central Research Institute of Epidemiology, Professor, Department of Infectious Diseases with Courses of Epidemiology and Phthisiology

Russian Federation, Moscow; Moscow

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