Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Sammer, R.
DO ANTIRETROVIRAL-DRUGS AFFECT THE CARDIOVASCULAR SYSTEM IN THE SOUTH AFRICAN POPULATION?
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2017. pp.
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Goswami Nandu
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- Abstract:
- Introduction: The HI-virus is known to cause an acceleration of endothelial dysfunction and cardiovascular disease. However, the antiretroviral therapy for the virus also has adverse effects on the cardiovascular system. Even though Sub-Saharan Africa is one of the global hotspots of HIV and AIDS, only limited research has been carried out in this area. Aims/Objectives: This thesis aims to explore differences in endothelial function in two HIV infected persons (one with and one without antiretroviral therapy) living in South Africa. Studying this is important as understanding the effects of ART per se on the cardiovascular system could lead to the development of guidelines for screening and treatment of HIV infected people, especially with respect to cardiovascular diseases. Material and Methods: Analysed in this work were two cases of mixed race, HIV infected South African females: one on HAART and one who was HIV naïve (HIV positive but not on treatment). Both women were examined in terms of traditional cardiovascular risk factors (BMI, serum lipid level, blood pressure) and endothelial function. The endothelial function was measured by means of non-invasive flow-mediated dilatation (FMD) of the brachial artery. Results: Both patients had been smoking and were pre-menopausal. The FMD measurement of the patient on HAART showed 6.14% dilation of the brachial artery, whereas the HIV naïve patient had a value of 12.56%. The patient on HAART was 18 years older, and had a BMI value of 29.5 kg/m³; her serum lipid results were: LDL 3.16 mmol/L, triglycerides 1.49 mmol/L and HDL 0.69 mmol/L. The HIV naïve patient had a BMI value of 48.3 kg/m³, and her serum lipid results were: LDL 2.64 mmol/L, Triglycerides 0.47 mmol/L and HDL 1.94 mmol/L. Discussion: Despite the lower BMI value and a physically more active lifestyle, the patient on HAART showed signs of an accelerated vascular aging and had a significantly worse endothelial response (as seen in the lower FMD values) than the HIV naïve patient. As both of these patients were relatively matched in anthropometric measurements (except age) it appears that the differential FMD values seen in the two patients could have arisen due to the adverse effects of the antiretroviral therapy. However, what role age and the phase of the menstrual cycle play in influencing the FMD results needs to be investigated in future studies and in larger cohorts of patients.