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Elevated N‐terminal prohormone of brain natriuretic peptide among persons living with HIV in a South African peri‐urban township

AIMS: Efforts to improve access to antiretroviral therapy (ART) have shifted morbidity and mortality among persons living with HIV (PLWH) from AIDS to non‐communicable diseases, such as cardiovascular disease (CVD). However, contemporary data on CVD among PLWH in sub‐Saharan Africa in the current AR...

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Autores principales: Peterson, Tess E., Baker, Jason V., Wong, Lye‐Yeng, Rupert, Adam, Ntusi, Ntobeko A. B., Esmail, Hanif, Wilkinson, Robert, Sereti, Irini, Meintjes, Graeme, Ntsekhe, Mpiko, Thienemann, Friedrich
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7524119/
https://www.ncbi.nlm.nih.gov/pubmed/32585776
http://dx.doi.org/10.1002/ehf2.12849
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author Peterson, Tess E.
Baker, Jason V.
Wong, Lye‐Yeng
Rupert, Adam
Ntusi, Ntobeko A. B.
Esmail, Hanif
Wilkinson, Robert
Sereti, Irini
Meintjes, Graeme
Ntsekhe, Mpiko
Thienemann, Friedrich
author_facet Peterson, Tess E.
Baker, Jason V.
Wong, Lye‐Yeng
Rupert, Adam
Ntusi, Ntobeko A. B.
Esmail, Hanif
Wilkinson, Robert
Sereti, Irini
Meintjes, Graeme
Ntsekhe, Mpiko
Thienemann, Friedrich
author_sort Peterson, Tess E.
collection PubMed
description AIMS: Efforts to improve access to antiretroviral therapy (ART) have shifted morbidity and mortality among persons living with HIV (PLWH) from AIDS to non‐communicable diseases, such as cardiovascular disease (CVD). However, contemporary data on CVD among PLWH in sub‐Saharan Africa in the current ART era are lacking. The aim of this study was to assess the burden of cardiac stress among PLWH in South Africa via measurement of N‐terminal prohormone of brain natriuretic peptide (NT‐proBNP). METHODS AND RESULTS: NT‐proBNP was measured at baseline in 224 PLWH enrolled in a sub‐study of a tuberculosis vaccine trial in Khayelitsha township near Cape Town, South Africa. Thresholds were applied at the assay's limit of detection (≥137 pg/mL) and a level indicative of symptomatic heart failure in the acute setting (>300 pg/mL). Mean (SD) age of participants was 39 (6) years, 86% were female, and 19% were hypertensive. Mean (SD) duration of HIV diagnosis was 8.3 (3.9) years and CD4 + count was 673 (267) with 79% prescribed ART for a duration of 5.6 (2.7) years. Thirty‐one percent of participants had NT‐proBNP > 300 pg/mL. Elevated vs. undetectable NT‐proBNP level was associated with older age (P = 0.04), no ART (P = 0.03), and higher plasma tumour necrosis factor‐α (P = 0.01). CONCLUSIONS: Among South African PLWH largely free of known CVD and on ART with high CD4 + counts and few comorbidities, we observed a high proportion with elevated NT‐proBNP levels, suggesting the burden of cardiac stress in this population may be high. This observation underscores the need for more in‐depth research, including the current effect of HIV on heart failure risk among a growing ART‐treated population in sub‐Saharan Africa.
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spelling pubmed-75241192020-10-02 Elevated N‐terminal prohormone of brain natriuretic peptide among persons living with HIV in a South African peri‐urban township Peterson, Tess E. Baker, Jason V. Wong, Lye‐Yeng Rupert, Adam Ntusi, Ntobeko A. B. Esmail, Hanif Wilkinson, Robert Sereti, Irini Meintjes, Graeme Ntsekhe, Mpiko Thienemann, Friedrich ESC Heart Fail Short Communications AIMS: Efforts to improve access to antiretroviral therapy (ART) have shifted morbidity and mortality among persons living with HIV (PLWH) from AIDS to non‐communicable diseases, such as cardiovascular disease (CVD). However, contemporary data on CVD among PLWH in sub‐Saharan Africa in the current ART era are lacking. The aim of this study was to assess the burden of cardiac stress among PLWH in South Africa via measurement of N‐terminal prohormone of brain natriuretic peptide (NT‐proBNP). METHODS AND RESULTS: NT‐proBNP was measured at baseline in 224 PLWH enrolled in a sub‐study of a tuberculosis vaccine trial in Khayelitsha township near Cape Town, South Africa. Thresholds were applied at the assay's limit of detection (≥137 pg/mL) and a level indicative of symptomatic heart failure in the acute setting (>300 pg/mL). Mean (SD) age of participants was 39 (6) years, 86% were female, and 19% were hypertensive. Mean (SD) duration of HIV diagnosis was 8.3 (3.9) years and CD4 + count was 673 (267) with 79% prescribed ART for a duration of 5.6 (2.7) years. Thirty‐one percent of participants had NT‐proBNP > 300 pg/mL. Elevated vs. undetectable NT‐proBNP level was associated with older age (P = 0.04), no ART (P = 0.03), and higher plasma tumour necrosis factor‐α (P = 0.01). CONCLUSIONS: Among South African PLWH largely free of known CVD and on ART with high CD4 + counts and few comorbidities, we observed a high proportion with elevated NT‐proBNP levels, suggesting the burden of cardiac stress in this population may be high. This observation underscores the need for more in‐depth research, including the current effect of HIV on heart failure risk among a growing ART‐treated population in sub‐Saharan Africa. John Wiley and Sons Inc. 2020-06-25 /pmc/articles/PMC7524119/ /pubmed/32585776 http://dx.doi.org/10.1002/ehf2.12849 Text en © 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Short Communications
Peterson, Tess E.
Baker, Jason V.
Wong, Lye‐Yeng
Rupert, Adam
Ntusi, Ntobeko A. B.
Esmail, Hanif
Wilkinson, Robert
Sereti, Irini
Meintjes, Graeme
Ntsekhe, Mpiko
Thienemann, Friedrich
Elevated N‐terminal prohormone of brain natriuretic peptide among persons living with HIV in a South African peri‐urban township
title Elevated N‐terminal prohormone of brain natriuretic peptide among persons living with HIV in a South African peri‐urban township
title_full Elevated N‐terminal prohormone of brain natriuretic peptide among persons living with HIV in a South African peri‐urban township
title_fullStr Elevated N‐terminal prohormone of brain natriuretic peptide among persons living with HIV in a South African peri‐urban township
title_full_unstemmed Elevated N‐terminal prohormone of brain natriuretic peptide among persons living with HIV in a South African peri‐urban township
title_short Elevated N‐terminal prohormone of brain natriuretic peptide among persons living with HIV in a South African peri‐urban township
title_sort elevated n‐terminal prohormone of brain natriuretic peptide among persons living with hiv in a south african peri‐urban township
topic Short Communications
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7524119/
https://www.ncbi.nlm.nih.gov/pubmed/32585776
http://dx.doi.org/10.1002/ehf2.12849
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