Non-communicable diseases (NCD) CFAR
An estimated 8 million people living with HIV/AIDS (PLWHA) in Sub-Saharan Africa are taking antiretroviral therapy (ART). As a result, HIV-related mortality has declined, adult life expectancy has increased, and the public health paradigm of HIV-care is shifting from improving early survival to improving long-term health and quality of life. A rapidly growing literature from resource-rich settings describes increased rates of hypertension, diabetes mellitus, atherosclerosis, myocardial infarction, and stroke in HIVinfected versus HIV-uninfected persons. Root causes of the elevated risk in PLWHA are hypothesized to
result from a multi-factorial process involving traditional cardiovascular risk factors, altered immune function, toxicity of ART, and the elevated inflammatory state associated with HIV infection. However, similar data on cardiovascular risk factors and outcomes are largely lacking from Sub-Saharan Africa, which is home to 70% of HIV-infected persons globally. Thus, there is a critical need to collect non-communicable disease epidemiologic data on PLWHA on ART to guide public health prioritization for this population.
The diverse expertise within our collaboration is uniquely positioned to perform clinical study of HIV-infected individuals in a rural, sub-Saharan African setting and to utilize state-of-the-art technology, including carotid ultrasonography, RNA deep sequencing for microbiome speciation, and flow cytometry for immune activation testing, to advance our understanding of cardiovascular disease epidemiology among HIV-infected persons in sub-Saharan Africa.
Data collected from this study will help will help serve multiple purposes, including: 1) identification of modifiable cardiovascular disease risk factors for PLWHA on ART in sub-Saharan Africa, 2) guidance of public health programs for monitoring and intervention on highest priority disease states, and 3) setting priorities for future areas of research for care of PLWHA in the region.
External PI: Mark Siedner
Coordinator: Ruth Nakku