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  1. Alinda Vos1,
  2. Walter Devillé2,
  3. Roos Barth3,
  4. Kerstin Klipstein-Grobusch1,
  5. Hugo Tempelman2,
  6. François Venter4,
  7. Roel Coutinho1,
  8. Diederick Grobbee1
  1. 1UMC Utrecht (Julius Center), The Netherlands
  2. 2Ndlovu Research Consortium, South Africa
  3. 3UMC Utrecht, The Netherlands
  4. 4Wits RHI, South Africa


Background Life expectancy increased in HIV-infected populations due to antiretroviral treatment (ART). Whether HIV-infection and/or ART increase cardiovascular risk against a background of increasing prevalence of obesity, hypertension and diabetes in low- and middle-income countries is not yet clear. To answer this question in a rural South-African population, the Ndlovu Cohort Study was designed. We describe the baseline distribution of cardiovascular risk factors in relation to HIV and ART.

Methods The Ndlovu Cohort Study is a prospective cohort study of 1000 HIV-positive and 1000 HIV-negative adults from the Moutse area, Limpopo, South Africa with an intended follow-up duration of ten years. Information is collected on demographics, anthropometrics, life-style, kidney and liver function, CRP, glucose and proteinuria. Carotid intima-media thickness (CIMT) and pulse wave velocity (PWV) measurements are used to assess subclinical atherosclerosis, respectively arterial stiffness. Cardiovascular risk factors were compared between HIV-negative and HIV – positive participants, whether or not on ART. Data were adjusted for gender and age.

Results By December 2015, 1053 participants were included, 66% women; 345 (32.8%) women were HIV-positive of whom 235 (68.1%) received ART. HIV-infected participants were significantly older (40.0 versus 37.3 years), and mainly women (73%). HIV was associated with a lower body mass index, lower total – and LDL cholesterol and a lower prevalence of hypertension and diabetes. ART was associated with increased HDL and triglyceride levels. Current smoking did not differ between groups (23.6%), HIV and ART were associated with higher CRP values. Framingham risk scores (FRS) did not differ between HIV+/HIV- and/or ART use.

Conclusions HIV infection is accompanied by a lower prevalence of cardiovascular risk factors, although the level of inflammation is increased. So far, we found no evidence that the 10-year cardiovascular disease risk according to FRS is influenced by HIV infection or HIV treatment.

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