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CD4 T CELL COUNT, ANTIRETROVIRAL THERAPY AND CARDIOVASCULAR COMPLICATIONS AMONG PEOPLE LIVING WITH HUMAN  IMMUNODEFICIENCY VIRUS (PLHIV)

PHRR220321-004443

CD4 T CELL COUNT, ANTIRETROVIRAL THERAPY AND CARDIOVASCULAR COMPLICATIONS AMONG PEOPLE LIVING WITH HUMAN  IMMUNODEFICIENCY VIRUS (PLHIV)

INTRODUCTION

The World Health Organization has seen a decline in the incidence of new HIV infection for the past decades. In contrast, the incidence of HIV infection in the Philippines has reached an unprecedented epidemic level. As of August 2021, 86,617 reported cases since January 1984 [1]. However, HIV prevalence is increasing worldwide because people on antiretroviral therapy (ART) live longer. Objectively, the expected life expectancy in patients starting ART has increased by about ten years during the ART era, though it remains lower than the general population [2]. The reduction of human immunodeficiency virus-related deaths by introducing ART has been challenged by increasing the incidence of non-HIV-related morbidity and mortality. Several pieces of evidence showed that HIV infection, even on medications, is a significant independent risk factor for coronary artery disease and, to some extent, heart failure (HF) [3]. Probably due to the increasing burden of HIV in low- and middle-income countries and the concurrent rise of traditional cardiovascular risk factors, strategic and concerted efforts in this area are likely to impact the care of people living with HIV worldwide.4 

The patients with HIV/AIDS and symptoms suggestive of cardiac disease represent a diagnostic and therapeutic challenge in clinical practice. However, there are not enough data to suggest that HF workup and therapy in patients with HIV differ from those used in the general population. Given that there are elevated risks for HF in HIV, it would be prudent for doctors engaged in the care of HIV patients to have a high suspicion index if their patients have cardiac symptoms and should have a low threshold to pursue noninvasive diagnostic testing [5]. 

 According to Triant et al. (2007), the development of cardiovascular diseases in HIV patients may have a relationship with the level of CD4 count and the types of ARV treatment received. Further, salient gaps exist in our understanding of HIV and its relationship to the development of cardiovascular diseases. The HIV providers lack evidence-based guidance on accurately predicting CVD risk and intervening to reduce the risk. Furthermore, the study of Triant et al. suggests that developing HIV-specific cardiovascular prevention strategies will vastly improve the care we provide to this at-risk population [6].  

Given the paucity of data in the Philippines, the researchers aim to identify a significant relationship between the CD4 count, the patients' duration of treatment, and the possible cardiovascular complications among people living with HIV in a tertiary hospital in Davao City, and to possibly establish the inclusion of cardiovascular diseases screening and possible reduction on the incidence of irreversible complications. 

RESEARCH QUESTIONS

  1. Is there any relationship of the level of CD4 count with the manifestations and severity of the cardiovascular complications?
  2. What are the cardiovascular complications of HIV infection?

SIGNIFICANCE OF THE STUDY

This study may help identify HIV patients with cardiovascular problems whether  or not they have received ARV treatment, since assessing risk for cardiovascular problems is not routinely done among HIV-infected individuals prior to initiating the ARV regimen. 

This study aims to identify the need to do baseline diagnostics modalities such as electrocardiogram and 2D echo prior to initiation of ARV treatment, and to do early stratification of the patients’ risk of developing cardiovascular complications. 

Regime Classification Priority
2017 - 2022 Diagnostics
Start Date Duration in Months Target Completion Date Actual Completion Date
2022-05-01 3 2022-08-01 0000-00-00

Pending

not stated

Institution Classification Region LTO #
Southern Philippines Medical Center Government Region XI
Institution Region
Southern Philiipines Medical Center Philippines
Name E-Mail Institution and Institution Address
Elson Elmo Serrano elsonelmo09@gmail.com Southern Philippines Medical Center (SPMC), JP Laurel Avenue Davao City
Name E-Mail Institution and Institution Address
Elson Elmo Serrano elsonelmo09@gmail.com Southern Philippines Medical Center (SPMC), JP Laurel Avenue Davao City
Name Expertise Affiliation
Elson Elmo Añana Serrano Internal Medicine Southern Philiipines Medical Center

This study may help identify HIV patients with cardiovascular problems whether  or not they have received ARV treatment, since assessing risk for cardiovascular problems is not routinely done among HIV-infected individuals prior to initiating the ARV regimen. 

This study aims to identify the need to do baseline diagnostics modalities such as electrocardiogram and 2D echo prior to initiation of ARV treatment, and to do early stratification of the patients’ risk of developing cardiovascular complications

The general objective of this study is to determine the cardiovascular complications of HIV.

Specifically, this study aims to:

  1. Describe the demographic and clinical profile of included participants based on sex, age, CD4 count, and duration of receiving treatment.
  2. Identify and determine the frequency of cardiac complications among HIV patients as to the presence of possible coronary artery disease, heart failure with both reserved and reduced ejection fraction, and presence of cardiac arrhythmia based on:
  1. Symptoms and physical examination findings
  2. 2D-Echocardiography (2D-Echo) findings 
  3. Electrocardiography (ECG)
  1. Determine relationship of CD4 count levels and the manifestation of cardiovascular complications
  2. Duration of ARV treatment and the manifestation of cardiac complications if:
  1. 1 year to 5 years
  2. >5 years

Pending

  • Philippines

Non-clinical Studies

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