Therapeutics and Clinical Risk Management (Sep 2018)

Changes in cardiovascular risk and clinical outcomes in a HIV/AIDS cohort study over a 1-year period at a specialized clinic in Mexico

  • Cibrián-Ponce A,
  • Sánchez-Alemán MA,
  • García-Jiménez S,
  • Pérez-Martínez E,
  • Bernal-Fernandez G,
  • Castañon-Mayo M,
  • Ávila-Jimenez L,
  • Toledano-Jaimes CD

Journal volume & issue
Vol. Volume 14
pp. 1757 – 1764

Abstract

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Angelica Cibrián-Ponce,1 Miguel A Sánchez-Alemán,2 Sara García-Jiménez,1 Eduardo Pérez-Martínez,3 Germán Bernal-Fernández,1 Miguel Castañon-Mayo,4 Laura Ávila-Jiménez,5 Cairo D Toledano-Jaimes1 1Faculty of Pharmacy, University of Morelos, Cuernavaca, Morelos, Mexico; 2Center for Infectious Diseases Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico; 3Retrovirus Clinic, Regional General Hospital Number 1, Cuernavaca, Morelos, Mexico; 4Nephrology Service, Regional General Hospital Number 1, Mexican Institute of Social Security, Morelos, Mexico; 5Health Research Morelos, Mexican Institute of Social Security, Morelos, Mexico Introduction: The third report of the National Cholesterol Education Program guidelines recommends calculating the 10-year morbidity of atherosclerotic cardiovascular disease (ASCVD) using risk calculators when treating high blood cholesterol in adults. We analyzed the changes in cardiovascular risk (CVR) among Mexican patients with HIV. Patients and methods: This observational, prospective cohort study compared the CVR after 1 year of antiretroviral treatment among 460 HIV patients from a Mexican clinic. Changes using the ASCVD risk estimator and changes in clinical outcomes were analyzed. The results were categorized as low or high CVR using a cutoff of 7.5%. Results: The CVR initially had a median of 2.3% (interquartile range [IQR]: 1%–4.8%), which changed to 2.4% (IQR: 1.5%–5.5%) after 1 year (P=0.001). After CVR stratification, we found that 84.3% of the patients had a low CVR, and 18% in this subgroup had metabolic syndrome (MS). Moreover, 15.7% had high CVR, and 47% in this subgroup had MS. The 4.3% of patients had an increase in CVR from the low to high subgroup, and 2.6% had a decrease in CVR from the high to low subgroup. Out of all patients, 22.3% had MS. Conclusion: More than 50% of the population had an increase in CVR after 1 year. Of these patients, 4.3% changed from the low to high CVR group. Although the guidelines proposed different time periods for performing CVR estimations, this study showed that such assessments offered valuable clinical data over a relatively short-term period. Keywords: cardiovascular risk factors, HIV, metabolic syndrome

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