Cardiovascular risk and endothelial function in people living with HIV/AIDS: design of the multi-site, longitudinal EndoAfrica study in the Western Cape Province of South Africa
Identifieur interne : 000300 ( Pmc/Checkpoint ); précédent : 000299; suivant : 000301Cardiovascular risk and endothelial function in people living with HIV/AIDS: design of the multi-site, longitudinal EndoAfrica study in the Western Cape Province of South Africa
Auteurs : Hans Strijdom [Afrique du Sud] ; Patrick De Boever [Belgique] ; Gerhard Walzl [Afrique du Sud] ; M. Faadiel Essop [Afrique du Sud] ; Tim S. Nawrot [Belgique] ; Ingrid Webster [Afrique du Sud] ; Corli Westcott [Afrique du Sud] ; Nyiko Mashele [Afrique du Sud] ; Frans Everson [Afrique du Sud] ; Stephanus T. Malherbe [Afrique du Sud] ; Kim Stanley [Afrique du Sud] ; Harald H. Kessler [Autriche] ; Evelyn Stelzl [Autriche] ; Nandu Goswami [Autriche]Source :
- BMC Infectious Diseases [ 1471-2334 ] ; 2017.
Abstract
There is growing evidence of an interaction between HIV-infection, anti-retroviral therapy (ART) and cardiovascular diseases (CVD). Epidemiological studies in Europe and North America have been observing a shift towards an increased incidence of coronary heart disease and acute myocardial infarctions in HIV-infected populations compared to the general population even after adjusting for traditional cardiovascular risk factors. Despite South Africa (and sub-Saharan Africa, SSA) being regarded as the epicentre of the global HIV epidemic, very little is known about the prevalence of cardiovascular risk factors and precursors of vascular disease in HIV-infected populations in this region. The knowledge gap is further widened by the paucity of data from prospective studies. We present the rationale, objectives and key methodological features of the EndoAfrica study, which aims to determine whether HIV-infection and ART are associated with altered cardiovascular risk and changes in vascular endothelial structure and function in adults living in the Western Cape Province of South Africa.
In this longitudinal study, comprehensive cardiovascular assessments of HIV-negative and HIV-positive (with and without ART) study participants are performed by clinical and biochemical screening for traditional cardiovascular risk factors and biomarkers of CVD. Vascular and endothelial function is determined by brachial artery flow-mediated dilatation (FMD), carotid-intima-thickness (IMT) measurements and quantitative retinal blood vessel analyses, complemented by vascular endothelial biomarker assays. Finally, we aim to statistically determine whether HIV-infection and/or ART are associated with increased cardiovascular risk and vascular endothelial dysfunction, and determine whether there is progression/regression in these endpoints 18 months after the baseline assessments.
The EndoAfrica study provides a unique opportunity to recruit a cohort of HIV-infected patients and HIV-negative controls who will be comprehensively and longitudinally assessed for cardiovascular risk and disease profile with vascular endothelial function as a potentially important intermediate cardiovascular phenotype. To our knowledge, it is the first time that such a systematic study has been established in the context of SSA and South Africa.
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DOI: 10.1186/s12879-016-2158-y
PubMed: 28061822
PubMed Central: 5219697
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Cardiovascular risk and endothelial function in people living with HIV/AIDS: design of the multi-site, longitudinal EndoAfrica study in the Western Cape Province of South Africa</title><author><name sortKey="Strijdom, Hans" sort="Strijdom, Hans" uniqKey="Strijdom H" first="Hans" last="Strijdom">Hans Strijdom</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000 South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="De Boever, Patrick" sort="De Boever, Patrick" uniqKey="De Boever P" first="Patrick" last="De Boever">Patrick De Boever</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Environmental Risk and Health Unit, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Environmental Risk and Health Unit, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol</wicri:regionArea><wicri:noRegion>2400 Mol</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff3">Centre for Environmental Studies, Hasselt University, Agoralaan, 3590 Diepenbeek, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Centre for Environmental Studies, Hasselt University, Agoralaan, 3590 Diepenbeek</wicri:regionArea><wicri:noRegion>3590 Diepenbeek</wicri:noRegion></affiliation></author><author><name sortKey="Walzl, Gerhard" sort="Walzl, Gerhard" uniqKey="Walzl G" first="Gerhard" last="Walzl">Gerhard Walzl</name><affiliation wicri:level="1"><nlm:aff id="Aff4">Division of Molecular Biology and Human Genetics, DST/NRF Centre of Excellence for Biomedical Tuberculosis Research and SAMRC Centre for Tuberculosis Research, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000 South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Division of Molecular Biology and Human Genetics, DST/NRF Centre of Excellence for Biomedical Tuberculosis Research and SAMRC Centre for Tuberculosis Research, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Essop, M Faadiel" sort="Essop, M Faadiel" uniqKey="Essop M" first="M. Faadiel" last="Essop">M. Faadiel Essop</name><affiliation wicri:level="1"><nlm:aff id="Aff5">Cardio-Metabolic Research Group (CMRG), Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, 7600 South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Cardio-Metabolic Research Group (CMRG), Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch</wicri:regionArea><wicri:noRegion>Stellenbosch</wicri:noRegion></affiliation></author><author><name sortKey="Nawrot, Tim S" sort="Nawrot, Tim S" uniqKey="Nawrot T" first="Tim S." last="Nawrot">Tim S. Nawrot</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Centre for Environmental Studies, Hasselt University, Agoralaan, 3590 Diepenbeek, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Centre for Environmental Studies, Hasselt University, Agoralaan, 3590 Diepenbeek</wicri:regionArea><wicri:noRegion>3590 Diepenbeek</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff6">Department of Public Health and Primary Care, Leuven University, Kapucijnenvoer 35, 3000 Leuven, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Public Health and Primary Care, Leuven University, Kapucijnenvoer 35, 3000 Leuven</wicri:regionArea><placeName><region type="province" nuts="2">Province du Brabant flamand</region><settlement type="city">Louvain</settlement></placeName></affiliation></author><author><name sortKey="Webster, Ingrid" sort="Webster, Ingrid" uniqKey="Webster I" first="Ingrid" last="Webster">Ingrid Webster</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000 South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Westcott, Corli" sort="Westcott, Corli" uniqKey="Westcott C" first="Corli" last="Westcott">Corli Westcott</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000 South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Mashele, Nyiko" sort="Mashele, Nyiko" uniqKey="Mashele N" first="Nyiko" last="Mashele">Nyiko Mashele</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000 South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Everson, Frans" sort="Everson, Frans" uniqKey="Everson F" first="Frans" last="Everson">Frans Everson</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000 South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Malherbe, Stephanus T" sort="Malherbe, Stephanus T" uniqKey="Malherbe S" first="Stephanus T." last="Malherbe">Stephanus T. Malherbe</name><affiliation wicri:level="1"><nlm:aff id="Aff4">Division of Molecular Biology and Human Genetics, DST/NRF Centre of Excellence for Biomedical Tuberculosis Research and SAMRC Centre for Tuberculosis Research, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000 South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Division of Molecular Biology and Human Genetics, DST/NRF Centre of Excellence for Biomedical Tuberculosis Research and SAMRC Centre for Tuberculosis Research, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Stanley, Kim" sort="Stanley, Kim" uniqKey="Stanley K" first="Kim" last="Stanley">Kim Stanley</name><affiliation wicri:level="1"><nlm:aff id="Aff4">Division of Molecular Biology and Human Genetics, DST/NRF Centre of Excellence for Biomedical Tuberculosis Research and SAMRC Centre for Tuberculosis Research, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000 South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Division of Molecular Biology and Human Genetics, DST/NRF Centre of Excellence for Biomedical Tuberculosis Research and SAMRC Centre for Tuberculosis Research, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Kessler, Harald H" sort="Kessler, Harald H" uniqKey="Kessler H" first="Harald H." last="Kessler">Harald H. Kessler</name><affiliation wicri:level="1"><nlm:aff id="Aff7">Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria</nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea>Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Universitätsplatz 4, 8010 Graz</wicri:regionArea><wicri:noRegion>8010 Graz</wicri:noRegion></affiliation></author><author><name sortKey="Stelzl, Evelyn" sort="Stelzl, Evelyn" uniqKey="Stelzl E" first="Evelyn" last="Stelzl">Evelyn Stelzl</name><affiliation wicri:level="1"><nlm:aff id="Aff7">Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria</nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea>Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Universitätsplatz 4, 8010 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Box 241, Cape Town, 8000 South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="De Boever, Patrick" sort="De Boever, Patrick" uniqKey="De Boever P" first="Patrick" last="De Boever">Patrick De Boever</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Environmental Risk and Health Unit, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Environmental Risk and Health Unit, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol</wicri:regionArea><wicri:noRegion>2400 Mol</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff3">Centre for Environmental Studies, Hasselt University, Agoralaan, 3590 Diepenbeek, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Centre for Environmental Studies, Hasselt University, Agoralaan, 3590 Diepenbeek</wicri:regionArea><wicri:noRegion>3590 Diepenbeek</wicri:noRegion></affiliation></author><author><name sortKey="Walzl, Gerhard" sort="Walzl, Gerhard" uniqKey="Walzl G" first="Gerhard" last="Walzl">Gerhard Walzl</name><affiliation wicri:level="1"><nlm:aff id="Aff4">Division of Molecular Biology and Human Genetics, DST/NRF Centre of Excellence for Biomedical Tuberculosis Research and SAMRC Centre for Tuberculosis Research, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000 South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Division of Molecular Biology and Human Genetics, DST/NRF Centre of Excellence for Biomedical Tuberculosis Research and SAMRC Centre for Tuberculosis Research, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Essop, M Faadiel" sort="Essop, M Faadiel" uniqKey="Essop M" first="M. Faadiel" last="Essop">M. Faadiel Essop</name><affiliation wicri:level="1"><nlm:aff id="Aff5">Cardio-Metabolic Research Group (CMRG), Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, 7600 South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Cardio-Metabolic Research Group (CMRG), Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch</wicri:regionArea><wicri:noRegion>Stellenbosch</wicri:noRegion></affiliation></author><author><name sortKey="Nawrot, Tim S" sort="Nawrot, Tim S" uniqKey="Nawrot T" first="Tim S." last="Nawrot">Tim S. Nawrot</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Centre for Environmental Studies, Hasselt University, Agoralaan, 3590 Diepenbeek, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Centre for Environmental Studies, Hasselt University, Agoralaan, 3590 Diepenbeek</wicri:regionArea><wicri:noRegion>3590 Diepenbeek</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff6">Department of Public Health and Primary Care, Leuven University, Kapucijnenvoer 35, 3000 Leuven, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Public Health and Primary Care, Leuven University, Kapucijnenvoer 35, 3000 Leuven</wicri:regionArea><placeName><region type="province" nuts="2">Province du Brabant flamand</region><settlement type="city">Louvain</settlement></placeName></affiliation></author><author><name sortKey="Webster, Ingrid" sort="Webster, Ingrid" uniqKey="Webster I" first="Ingrid" last="Webster">Ingrid Webster</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000 South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Westcott, Corli" sort="Westcott, Corli" uniqKey="Westcott C" first="Corli" last="Westcott">Corli Westcott</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000 South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Mashele, Nyiko" sort="Mashele, Nyiko" uniqKey="Mashele N" first="Nyiko" last="Mashele">Nyiko Mashele</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000 South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Everson, Frans" sort="Everson, Frans" uniqKey="Everson F" first="Frans" last="Everson">Frans Everson</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000 South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Malherbe, Stephanus T" sort="Malherbe, Stephanus T" uniqKey="Malherbe S" first="Stephanus T." last="Malherbe">Stephanus T. Malherbe</name><affiliation wicri:level="1"><nlm:aff id="Aff4">Division of Molecular Biology and Human Genetics, DST/NRF Centre of Excellence for Biomedical Tuberculosis Research and SAMRC Centre for Tuberculosis Research, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000 South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Division of Molecular Biology and Human Genetics, DST/NRF Centre of Excellence for Biomedical Tuberculosis Research and SAMRC Centre for Tuberculosis Research, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Stanley, Kim" sort="Stanley, Kim" uniqKey="Stanley K" first="Kim" last="Stanley">Kim Stanley</name><affiliation wicri:level="1"><nlm:aff id="Aff4">Division of Molecular Biology and Human Genetics, DST/NRF Centre of Excellence for Biomedical Tuberculosis Research and SAMRC Centre for Tuberculosis Research, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000 South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Division of Molecular Biology and Human Genetics, DST/NRF Centre of Excellence for Biomedical Tuberculosis Research and SAMRC Centre for Tuberculosis Research, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Kessler, Harald H" sort="Kessler, Harald H" uniqKey="Kessler H" first="Harald H." last="Kessler">Harald H. Kessler</name><affiliation wicri:level="1"><nlm:aff id="Aff7">Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria</nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea>Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Universitätsplatz 4, 8010 Graz</wicri:regionArea><wicri:noRegion>8010 Graz</wicri:noRegion></affiliation></author><author><name sortKey="Stelzl, Evelyn" sort="Stelzl, Evelyn" uniqKey="Stelzl E" first="Evelyn" last="Stelzl">Evelyn Stelzl</name><affiliation wicri:level="1"><nlm:aff id="Aff7">Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria</nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea>Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Universitätsplatz 4, 8010 Graz</wicri:regionArea><wicri:noRegion>8010 Graz</wicri:noRegion></affiliation></author><author><name sortKey="Goswami, Nandu" sort="Goswami, Nandu" uniqKey="Goswami N" first="Nandu" last="Goswami">Nandu Goswami</name><affiliation wicri:level="1"><nlm:aff id="Aff8">Gravitational Physiology and Medicine Research Unit, Institute of Physiology, Medical University of Graz, Harrachgasse 21/V, 8010 Graz, Austria</nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea>Gravitational Physiology and Medicine Research Unit, Institute of Physiology, Medical University of Graz, Harrachgasse 21/V, 8010 Graz</wicri:regionArea><wicri:noRegion>8010 Graz</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Infectious Diseases</title><idno type="eISSN">1471-2334</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>There is growing evidence of an interaction between HIV-infection, anti-retroviral therapy (ART) and cardiovascular diseases (CVD). Epidemiological studies in Europe and North America have been observing a shift towards an increased incidence of coronary heart disease and acute myocardial infarctions in HIV-infected populations compared to the general population even after adjusting for traditional cardiovascular risk factors. Despite South Africa (and sub-Saharan Africa, SSA) being regarded as the epicentre of the global HIV epidemic, very little is known about the prevalence of cardiovascular risk factors and precursors of vascular disease in HIV-infected populations in this region. The knowledge gap is further widened by the paucity of data from prospective studies. We present the rationale, objectives and key methodological features of the EndoAfrica study, which aims to determine whether HIV-infection and ART are associated with altered cardiovascular risk and changes in vascular endothelial structure and function in adults living in the Western Cape Province of South Africa.</p></sec><sec><title>Methods</title><p>In this longitudinal study, comprehensive cardiovascular assessments of HIV-negative and HIV-positive (with and without ART) study participants are performed by clinical and biochemical screening for traditional cardiovascular risk factors and biomarkers of CVD. Vascular and endothelial function is determined by brachial artery flow-mediated dilatation (FMD), carotid-intima-thickness (IMT) measurements and quantitative retinal blood vessel analyses, complemented by vascular endothelial biomarker assays. Finally, we aim to statistically determine whether HIV-infection and/or ART are associated with increased cardiovascular risk and vascular endothelial dysfunction, and determine whether there is progression/regression in these endpoints 18 months after the baseline assessments.</p></sec><sec><title>Discussion</title><p>The EndoAfrica study provides a unique opportunity to recruit a cohort of HIV-infected patients and HIV-negative controls who will be comprehensively and longitudinally assessed for cardiovascular risk and disease profile with vascular endothelial function as a potentially important intermediate cardiovascular phenotype. To our knowledge, it is the first time that such a systematic study has been established in the context of SSA and South Africa.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Boccara, F" uniqKey="Boccara F">F Boccara</name></author><author><name sortKey="Lang, S" uniqKey="Lang S">S Lang</name></author><author><name sortKey="Meuleman, C" uniqKey="Meuleman C">C Meuleman</name></author><author><name sortKey="Ederhy, S" uniqKey="Ederhy S">S Ederhy</name></author><author><name sortKey="Mary Krause, M" uniqKey="Mary Krause M">M Mary-Krause</name></author><author><name sortKey="Costagliola, D" uniqKey="Costagliola D">D Costagliola</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Levy, Ws" uniqKey="Levy W">WS Levy</name></author><author><name sortKey="Simon, Gl" uniqKey="Simon G">GL Simon</name></author><author><name sortKey="Rios, Jc" uniqKey="Rios J">JC Rios</name></author><author><name 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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Infect Dis</journal-id><journal-id journal-id-type="iso-abbrev">BMC Infect. Dis</journal-id><journal-title-group><journal-title>BMC Infectious Diseases</journal-title></journal-title-group><issn pub-type="epub">1471-2334</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28061822</article-id><article-id pub-id-type="pmc">5219697</article-id><article-id pub-id-type="publisher-id">2158</article-id><article-id pub-id-type="doi">10.1186/s12879-016-2158-y</article-id><article-categories><subj-group subj-group-type="heading"><subject>Study Protocol</subject></subj-group></article-categories><title-group><article-title>Cardiovascular risk and endothelial function in people living with HIV/AIDS: design of the multi-site, longitudinal EndoAfrica study in the Western Cape Province of South Africa</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0003-3726-9153</contrib-id><name><surname>Strijdom</surname><given-names>Hans</given-names></name><address><email>jgstr@sun.ac.za</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>De Boever</surname><given-names>Patrick</given-names></name><xref ref-type="aff" rid="Aff2">2</xref><xref ref-type="aff" rid="Aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Walzl</surname><given-names>Gerhard</given-names></name><xref ref-type="aff" rid="Aff4">4</xref></contrib><contrib contrib-type="author"><name><surname>Essop</surname><given-names>M. Faadiel</given-names></name><xref ref-type="aff" rid="Aff5">5</xref></contrib><contrib contrib-type="author"><name><surname>Nawrot</surname><given-names>Tim S.</given-names></name><xref ref-type="aff" rid="Aff3">3</xref><xref ref-type="aff" rid="Aff6">6</xref></contrib><contrib contrib-type="author"><name><surname>Webster</surname><given-names>Ingrid</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Westcott</surname><given-names>Corli</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Mashele</surname><given-names>Nyiko</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Everson</surname><given-names>Frans</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Malherbe</surname><given-names>Stephanus T.</given-names></name><xref ref-type="aff" rid="Aff4">4</xref></contrib><contrib contrib-type="author"><name><surname>Stanley</surname><given-names>Kim</given-names></name><xref ref-type="aff" rid="Aff4">4</xref></contrib><contrib contrib-type="author"><name><surname>Kessler</surname><given-names>Harald H.</given-names></name><xref ref-type="aff" rid="Aff7">7</xref></contrib><contrib contrib-type="author"><name><surname>Stelzl</surname><given-names>Evelyn</given-names></name><xref ref-type="aff" rid="Aff7">7</xref></contrib><contrib contrib-type="author"><name><surname>Goswami</surname><given-names>Nandu</given-names></name><xref ref-type="aff" rid="Aff8">8</xref></contrib><aff id="Aff1"><label>1</label>Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000 South Africa</aff><aff id="Aff2"><label>2</label>Environmental Risk and Health Unit, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium</aff><aff id="Aff3"><label>3</label>Centre for Environmental Studies, Hasselt University, Agoralaan, 3590 Diepenbeek, Belgium</aff><aff id="Aff4"><label>4</label>Division of Molecular Biology and Human Genetics, DST/NRF Centre of Excellence for Biomedical Tuberculosis Research and SAMRC Centre for Tuberculosis Research, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000 South Africa</aff><aff id="Aff5"><label>5</label>Cardio-Metabolic Research Group (CMRG), Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, 7600 South Africa</aff><aff id="Aff6"><label>6</label>Department of Public Health and Primary Care, Leuven University, Kapucijnenvoer 35, 3000 Leuven, Belgium</aff><aff id="Aff7"><label>7</label>Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria</aff><aff id="Aff8"><label>8</label>Gravitational Physiology and Medicine Research Unit, Institute of Physiology, Medical University of Graz, Harrachgasse 21/V, 8010 Graz, Austria</aff></contrib-group><pub-date pub-type="epub"><day>7</day><month>1</month><year>2017</year></pub-date><pub-date pub-type="pmc-release"><day>7</day><month>1</month><year>2017</year></pub-date><pub-date pub-type="collection"><year>2017</year></pub-date><volume>17</volume><elocation-id>41</elocation-id><history><date date-type="received"><day>7</day><month>12</month><year>2016</year></date><date date-type="accepted"><day>22</day><month>12</month><year>2016</year></date></history><permissions><copyright-statement>© The Author(s). 2017</copyright-statement><license license-type="OpenAccess"><license-p><bold>Open Access</bold>This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p>There is growing evidence of an interaction between HIV-infection, anti-retroviral therapy (ART) and cardiovascular diseases (CVD). Epidemiological studies in Europe and North America have been observing a shift towards an increased incidence of coronary heart disease and acute myocardial infarctions in HIV-infected populations compared to the general population even after adjusting for traditional cardiovascular risk factors. Despite South Africa (and sub-Saharan Africa, SSA) being regarded as the epicentre of the global HIV epidemic, very little is known about the prevalence of cardiovascular risk factors and precursors of vascular disease in HIV-infected populations in this region. The knowledge gap is further widened by the paucity of data from prospective studies. We present the rationale, objectives and key methodological features of the EndoAfrica study, which aims to determine whether HIV-infection and ART are associated with altered cardiovascular risk and changes in vascular endothelial structure and function in adults living in the Western Cape Province of South Africa.</p></sec><sec><title>Methods</title><p>In this longitudinal study, comprehensive cardiovascular assessments of HIV-negative and HIV-positive (with and without ART) study participants are performed by clinical and biochemical screening for traditional cardiovascular risk factors and biomarkers of CVD. Vascular and endothelial function is determined by brachial artery flow-mediated dilatation (FMD), carotid-intima-thickness (IMT) measurements and quantitative retinal blood vessel analyses, complemented by vascular endothelial biomarker assays. Finally, we aim to statistically determine whether HIV-infection and/or ART are associated with increased cardiovascular risk and vascular endothelial dysfunction, and determine whether there is progression/regression in these endpoints 18 months after the baseline assessments.</p></sec><sec><title>Discussion</title><p>The EndoAfrica study provides a unique opportunity to recruit a cohort of HIV-infected patients and HIV-negative controls who will be comprehensively and longitudinally assessed for cardiovascular risk and disease profile with vascular endothelial function as a potentially important intermediate cardiovascular phenotype. To our knowledge, it is the first time that such a systematic study has been established in the context of SSA and South Africa.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>HIV</kwd><kwd>Antiretroviral therapy</kwd><kwd>Cardiovascular risk factors</kwd><kwd>Vascular endothelial function</kwd><kwd>South Africa</kwd></kwd-group><funding-group><award-group><funding-source><institution-wrap><institution-id institution-id-type="FundRef">http://dx.doi.org/10.13039/501100001342</institution-id><institution>Department of Science and Technology, Republic of South Africa</institution></institution-wrap></funding-source><award-id>DST/CON 0077/2014</award-id><principal-award-recipient><name><surname>Strijdom</surname><given-names>Hans</given-names></name></principal-award-recipient></award-group><award-group><funding-source><institution-wrap><institution-id institution-id-type="FundRef">http://dx.doi.org/10.13039/501100001321</institution-id><institution>National Research Foundation</institution></institution-wrap></funding-source></award-group><award-group><funding-source><institution>Belgian Science Policy</institution></funding-source><award-id>BL/67/eranet03</award-id><award-id>BL/67/eranet03</award-id><principal-award-recipient><name><surname>De Boever</surname><given-names>Patrick</given-names></name></principal-award-recipient></award-group><award-group><funding-source><institution-wrap><institution-id institution-id-type="FundRef">http://dx.doi.org/10.13039/501100005012</institution-id><institution>Österreichische Agentur für Internationale Mobilität und Kooperation in Bildung, Wissenschaft und Forschung</institution></institution-wrap></funding-source></award-group></funding-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2017</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc><affiliations><list><country><li>Afrique du Sud</li><li>Autriche</li><li>Belgique</li></country><region><li>Province du Brabant flamand</li></region><settlement><li>Louvain</li></settlement></list><tree><country name="Afrique du Sud"><noRegion><name sortKey="Strijdom, Hans" sort="Strijdom, Hans" uniqKey="Strijdom H" first="Hans" last="Strijdom">Hans Strijdom</name></noRegion><name sortKey="Essop, M Faadiel" sort="Essop, M Faadiel" uniqKey="Essop M" first="M. Faadiel" last="Essop">M. Faadiel Essop</name><name sortKey="Everson, Frans" sort="Everson, Frans" uniqKey="Everson F" first="Frans" last="Everson">Frans Everson</name><name sortKey="Malherbe, Stephanus T" sort="Malherbe, Stephanus T" uniqKey="Malherbe S" first="Stephanus T." last="Malherbe">Stephanus T. Malherbe</name><name sortKey="Mashele, Nyiko" sort="Mashele, Nyiko" uniqKey="Mashele N" first="Nyiko" last="Mashele">Nyiko Mashele</name><name sortKey="Stanley, Kim" sort="Stanley, Kim" uniqKey="Stanley K" first="Kim" last="Stanley">Kim Stanley</name><name sortKey="Walzl, Gerhard" sort="Walzl, Gerhard" uniqKey="Walzl G" first="Gerhard" last="Walzl">Gerhard Walzl</name><name sortKey="Webster, Ingrid" sort="Webster, Ingrid" uniqKey="Webster I" first="Ingrid" last="Webster">Ingrid Webster</name><name sortKey="Westcott, Corli" sort="Westcott, Corli" uniqKey="Westcott C" first="Corli" last="Westcott">Corli Westcott</name></country><country name="Belgique"><noRegion><name sortKey="De Boever, Patrick" sort="De Boever, Patrick" uniqKey="De Boever P" first="Patrick" last="De Boever">Patrick De Boever</name></noRegion><name sortKey="De Boever, Patrick" sort="De Boever, Patrick" uniqKey="De Boever P" first="Patrick" last="De Boever">Patrick De Boever</name><name sortKey="Nawrot, Tim S" sort="Nawrot, Tim S" uniqKey="Nawrot T" first="Tim S." last="Nawrot">Tim S. Nawrot</name><name sortKey="Nawrot, Tim S" sort="Nawrot, Tim S" uniqKey="Nawrot T" first="Tim S." last="Nawrot">Tim S. Nawrot</name></country><country name="Autriche"><noRegion><name sortKey="Kessler, Harald H" sort="Kessler, Harald H" uniqKey="Kessler H" first="Harald H." last="Kessler">Harald H. Kessler</name></noRegion><name sortKey="Goswami, Nandu" sort="Goswami, Nandu" uniqKey="Goswami N" first="Nandu" last="Goswami">Nandu Goswami</name><name sortKey="Stelzl, Evelyn" sort="Stelzl, Evelyn" uniqKey="Stelzl E" first="Evelyn" last="Stelzl">Evelyn Stelzl</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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