HIV treatment is associated with a twofold higher probability of raised triglycerides: Pooled analyses in 21 023 individuals in sub-Saharan Africa

Kenneth Ekoru; Elizabeth H Young; David G Dillon; Deepti Gurdasani; Nathan Stehouwer; Daniel Faurholt-Jepsen; Naomi S Levitt; Nigel J Crowther; Moffat Nyirenda; Marina A Njelekela; Kaushik Ramaiya; Ousman Nyan; Olanisun O Adewole; Kathryn Anastos; Caterina Compostella; Joel A Dave; Carla M Fourie; Henrik Friis; Iolanthe M Kruger; Chris T Longenecker; Dermot P Maher; Eugene Mutimura; Chiratidzo E Ndhlovu; George Praygod; Eric W Pefura Yone; Mar Pujades-Rodriguez; Nyagosya Range; Mahmoud U Sani; Muhammad Sanusi; Aletta E Schutte; Karen Sliwa; Phyllis C Tien; Este H Vorster; Corinna Walsh; Dickman Gareta; Fredirick Mashili; Eugene Sobngwi; Clement Adebamowo; Anatoli Kamali; Janet Seeley; Liam Smeeth; Deenan Pillay; Ayesha A Motala; Pontiano Kaleebu; Manjinder S Sandhu

doi:10.1017/gheg.2018.7

HIV treatment is associated with a twofold higher probability of raised triglycerides: Pooled analyses in 21 023 individuals in sub-Saharan Africa

Kenneth Ekoru, Elizabeth H Young, David G Dillon, Deepti Gurdasani, Nathan Stehouwer, Daniel Faurholt-Jepsen, Naomi S Levitt, Nigel J Crowther, Moffat Nyirenda, Marina A Njelekela, Kaushik Ramaiya, Ousman Nyan, Olanisun O Adewole, Kathryn Anastos, Caterina Compostella, Joel A Dave, Carla M Fourie, Henrik Friis, Iolanthe M Kruger, Chris T LongeneckerDermot P Maher, Eugene Mutimura, Chiratidzo E Ndhlovu, George Praygod, Eric W Pefura Yone, Mar Pujades-Rodriguez, Nyagosya Range, Mahmoud U Sani, Muhammad Sanusi, Aletta E Schutte, Karen Sliwa, Phyllis C Tien, Este H Vorster, Corinna Walsh, Dickman Gareta, Fredirick Mashili, Eugene Sobngwi, Clement Adebamowo, Anatoli Kamali, Janet Seeley, Liam Smeeth, Deenan Pillay, Ayesha A Motala, Pontiano Kaleebu, Manjinder S Sandhu

Lifecourse Nutrition & Health

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Abstract

Background Anti-retroviral therapy (ART) regimes for HIV are associated with raised levels of circulating triglycerides (TGs) in western populations. However, there are limited data on the impact of ART on cardiometabolic risk in sub-Saharan African (SSA) populations.Methods Pooled analyses of 14 studies comprising 21 023 individuals, on whom relevant cardiometabolic risk factors (including TG), HIV and ART status were assessed between 2003 and 2014, in SSA. The association between ART and raised TG (>2.3 mmol/L) was analysed using regression models.Findings Among 10 615 individuals, ART was associated with a two-fold higher probability of raised TG (RR 2.05, 95% CI 1.51-2.77, I2 = 45.2%). The associations between ART and raised blood pressure, glucose, HbA1c, and other lipids were inconsistent across studies.Interpretation Evidence from this study confirms the association of ART with raised TG in SSA populations. Given the possible causal effect of raised TG on cardiovascular disease (CVD), the evidence highlights the need for prospective studies to clarify the impact of long term ART on CVD outcomes in SSA.

Original language	English
Article number	e7
Journal	Global Health, Epidemiology and Genomics
Volume	3
Number of pages	13
ISSN	2054-4200
DOIs	https://doi.org/10.1017/gheg.2018.7
Publication status	Published - 2018

Keywords

Faculty of Science
Antiretroviral therapy
Cardiovascular disease
HIV
Lipids
Sub-Saharan Africa
Triglycerides

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Ekoru et al_Global Health Epidemiology and Genomics_2018_Vol 3_e7Final published version, 1.15 MBLicence: CC BY

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Ekoru, K., Young, E. H., Dillon, D. G., Gurdasani, D., Stehouwer, N., Faurholt-Jepsen, D., Levitt, N. S., Crowther, N. J., Nyirenda, M., Njelekela, M. A., Ramaiya, K., Nyan, O., Adewole, O. O., Anastos, K., Compostella, C., Dave, J. A., Fourie, C. M., Friis, H., Kruger, I. M., ... Sandhu, M. S. (2018). HIV treatment is associated with a twofold higher probability of raised triglycerides: Pooled analyses in 21 023 individuals in sub-Saharan Africa. Global Health, Epidemiology and Genomics, 3, Article e7. https://doi.org/10.1017/gheg.2018.7

Ekoru, K, Young, EH, Dillon, DG, Gurdasani, D, Stehouwer, N, Faurholt-Jepsen, D, Levitt, NS, Crowther, NJ, Nyirenda, M, Njelekela, MA, Ramaiya, K, Nyan, O, Adewole, OO, Anastos, K, Compostella, C, Dave, JA, Fourie, CM, Friis, H, Kruger, IM, Longenecker, CT, Maher, DP, Mutimura, E, Ndhlovu, CE, Praygod, G, Pefura Yone, EW, Pujades-Rodriguez, M, Range, N, Sani, MU, Sanusi, M, Schutte, AE, Sliwa, K, Tien, PC, Vorster, EH, Walsh, C, Gareta, D, Mashili, F, Sobngwi, E, Adebamowo, C, Kamali, A, Seeley, J, Smeeth, L, Pillay, D, Motala, AA, Kaleebu, P & Sandhu, MS 2018, 'HIV treatment is associated with a twofold higher probability of raised triglycerides: Pooled analyses in 21 023 individuals in sub-Saharan Africa', Global Health, Epidemiology and Genomics, vol. 3, e7. https://doi.org/10.1017/gheg.2018.7

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title = "HIV treatment is associated with a twofold higher probability of raised triglycerides: Pooled analyses in 21 023 individuals in sub-Saharan Africa",

abstract = "Background Anti-retroviral therapy (ART) regimes for HIV are associated with raised levels of circulating triglycerides (TGs) in western populations. However, there are limited data on the impact of ART on cardiometabolic risk in sub-Saharan African (SSA) populations.Methods Pooled analyses of 14 studies comprising 21 023 individuals, on whom relevant cardiometabolic risk factors (including TG), HIV and ART status were assessed between 2003 and 2014, in SSA. The association between ART and raised TG (>2.3 mmol/L) was analysed using regression models.Findings Among 10 615 individuals, ART was associated with a two-fold higher probability of raised TG (RR 2.05, 95% CI 1.51-2.77, I2 = 45.2%). The associations between ART and raised blood pressure, glucose, HbA1c, and other lipids were inconsistent across studies.Interpretation Evidence from this study confirms the association of ART with raised TG in SSA populations. Given the possible causal effect of raised TG on cardiovascular disease (CVD), the evidence highlights the need for prospective studies to clarify the impact of long term ART on CVD outcomes in SSA.",

keywords = "Faculty of Science, Antiretroviral therapy, Cardiovascular disease, HIV, Lipids, Sub-Saharan Africa, Triglycerides",

author = "Kenneth Ekoru and Young, {Elizabeth H} and Dillon, {David G} and Deepti Gurdasani and Nathan Stehouwer and Daniel Faurholt-Jepsen and Levitt, {Naomi S} and Crowther, {Nigel J} and Moffat Nyirenda and Njelekela, {Marina A} and Kaushik Ramaiya and Ousman Nyan and Adewole, {Olanisun O} and Kathryn Anastos and Caterina Compostella and Dave, {Joel A} and Fourie, {Carla M} and Henrik Friis and Kruger, {Iolanthe M} and Longenecker, {Chris T} and Maher, {Dermot P} and Eugene Mutimura and Ndhlovu, {Chiratidzo E} and George Praygod and {Pefura Yone}, {Eric W} and Mar Pujades-Rodriguez and Nyagosya Range and Sani, {Mahmoud U} and Muhammad Sanusi and Schutte, {Aletta E} and Karen Sliwa and Tien, {Phyllis C} and Vorster, {Este H} and Corinna Walsh and Dickman Gareta and Fredirick Mashili and Eugene Sobngwi and Clement Adebamowo and Anatoli Kamali and Janet Seeley and Liam Smeeth and Deenan Pillay and Motala, {Ayesha A} and Pontiano Kaleebu and Sandhu, {Manjinder S}",

note = "CURIS 2018 NEXS 198",

year = "2018",

doi = "10.1017/gheg.2018.7",

language = "English",

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journal = "Global Health, Epidemiology and Genomics",

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publisher = "Cambridge University Press",

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TY - JOUR

T1 - HIV treatment is associated with a twofold higher probability of raised triglycerides

T2 - Pooled analyses in 21 023 individuals in sub-Saharan Africa

AU - Ekoru, Kenneth

AU - Young, Elizabeth H

AU - Dillon, David G

AU - Gurdasani, Deepti

AU - Stehouwer, Nathan

AU - Faurholt-Jepsen, Daniel

AU - Levitt, Naomi S

AU - Crowther, Nigel J

AU - Nyirenda, Moffat

AU - Njelekela, Marina A

AU - Ramaiya, Kaushik

AU - Nyan, Ousman

AU - Adewole, Olanisun O

AU - Anastos, Kathryn

AU - Compostella, Caterina

AU - Dave, Joel A

AU - Fourie, Carla M

AU - Friis, Henrik

AU - Kruger, Iolanthe M

AU - Longenecker, Chris T

AU - Maher, Dermot P

AU - Mutimura, Eugene

AU - Ndhlovu, Chiratidzo E

AU - Praygod, George

AU - Pefura Yone, Eric W

AU - Pujades-Rodriguez, Mar

AU - Range, Nyagosya

AU - Sani, Mahmoud U

AU - Sanusi, Muhammad

AU - Schutte, Aletta E

AU - Sliwa, Karen

AU - Tien, Phyllis C

AU - Vorster, Este H

AU - Walsh, Corinna

AU - Gareta, Dickman

AU - Mashili, Fredirick

AU - Sobngwi, Eugene

AU - Adebamowo, Clement

AU - Kamali, Anatoli

AU - Seeley, Janet

AU - Smeeth, Liam

AU - Pillay, Deenan

AU - Motala, Ayesha A

AU - Kaleebu, Pontiano

AU - Sandhu, Manjinder S

N1 - CURIS 2018 NEXS 198

PY - 2018

Y1 - 2018

N2 - Background Anti-retroviral therapy (ART) regimes for HIV are associated with raised levels of circulating triglycerides (TGs) in western populations. However, there are limited data on the impact of ART on cardiometabolic risk in sub-Saharan African (SSA) populations.Methods Pooled analyses of 14 studies comprising 21 023 individuals, on whom relevant cardiometabolic risk factors (including TG), HIV and ART status were assessed between 2003 and 2014, in SSA. The association between ART and raised TG (>2.3 mmol/L) was analysed using regression models.Findings Among 10 615 individuals, ART was associated with a two-fold higher probability of raised TG (RR 2.05, 95% CI 1.51-2.77, I2 = 45.2%). The associations between ART and raised blood pressure, glucose, HbA1c, and other lipids were inconsistent across studies.Interpretation Evidence from this study confirms the association of ART with raised TG in SSA populations. Given the possible causal effect of raised TG on cardiovascular disease (CVD), the evidence highlights the need for prospective studies to clarify the impact of long term ART on CVD outcomes in SSA.

AB - Background Anti-retroviral therapy (ART) regimes for HIV are associated with raised levels of circulating triglycerides (TGs) in western populations. However, there are limited data on the impact of ART on cardiometabolic risk in sub-Saharan African (SSA) populations.Methods Pooled analyses of 14 studies comprising 21 023 individuals, on whom relevant cardiometabolic risk factors (including TG), HIV and ART status were assessed between 2003 and 2014, in SSA. The association between ART and raised TG (>2.3 mmol/L) was analysed using regression models.Findings Among 10 615 individuals, ART was associated with a two-fold higher probability of raised TG (RR 2.05, 95% CI 1.51-2.77, I2 = 45.2%). The associations between ART and raised blood pressure, glucose, HbA1c, and other lipids were inconsistent across studies.Interpretation Evidence from this study confirms the association of ART with raised TG in SSA populations. Given the possible causal effect of raised TG on cardiovascular disease (CVD), the evidence highlights the need for prospective studies to clarify the impact of long term ART on CVD outcomes in SSA.

KW - Faculty of Science

KW - Antiretroviral therapy

KW - Cardiovascular disease

KW - HIV

KW - Lipids

KW - Sub-Saharan Africa

KW - Triglycerides

U2 - 10.1017/gheg.2018.7

DO - 10.1017/gheg.2018.7

M3 - Journal article

C2 - 29881632

SN - 2054-4200

VL - 3

JO - Global Health, Epidemiology and Genomics

JF - Global Health, Epidemiology and Genomics

M1 - e7

ER -

HIV treatment is associated with a twofold higher probability of raised triglycerides: Pooled analyses in 21 023 individuals in sub-Saharan Africa

Abstract

Keywords

UN SDGs

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