For release at 3:00 p.m. ET on Wednesday 12 March 2025
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Below please find a summary of a new article that has published in Annals of Internal Medicine following an oral presentation at the Conference on Retroviruses and Opportunistic Infections (CROI) in San Francisco, CA. The summary is not intended to substitute for the full article as a source of information.
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HIV not associated with higher risk for coronary artery disease in Uganda, challenging prior notions of health risks among regional populations with HIV
Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-24-02233
Editorial: https://www.acpjournals.org/doi/10.7326/ANNALS-24-03940
A cross-sectional study of adults in Uganda with and without HIV was conducted to estimate the prevalence of coronary atherosclerosis disease (CAD) in Uganda and determine whether well-controlled HIV infection is associated with increased presence or severity of CAD. The study found the prevalence of CAD among people with and without HIV in Uganda is much lower than in similar populations in the Global North. The results challenge the notion that CAD is a major cause of morbidity in Uganda. The study is published in Annals of Internal Medicine following an oral presentation at the Conference on Retroviruses and Opportunistic Infections (CROI) in San Francisco, CA.
Researchers from Massachusetts General Hospital and colleagues studied data from 586 adults older than age 40 with and without HIV in Southwestern Uganda. People living with HIV (PWH) were eligible to participate if they were receiving clinical care at a nearby Immune Suppression Syndrome Clinic or HIV Clinic and were taking antiretroviral therapy (ART) for at least three years. People without HIV (PWoH) included in the study had to live within 20 km of the HIV clinics and were age and sex similar to PWH. Coronary CT angiography (CCTA) scans were performed on the participants and a radiologist and three CV imaging fellows who were blinded to HV serostatus analyzed the CCTA results. The primary outcome was the presence of CAD, defined by any plaque on CCTA in at least one of the major coronary arteries, or an Agatston CAC score greater than zero. Additionally, this research was done at a time and place in Uganda when HIV medicines were available and nearly all participants in the study had achieved virologic suppression.
The researchers found that among PWH taking ART in public-sector clinical care in Uganda, prevalence of CAD was low. For both PWH and PWoH, prevalence of CAD was less than 10% and the prevalence of a CAC score greater than one was three percent. The findings suggest the prevalence of CAD among PWH in Uganda is much lower than high-income regions like the United States and Europe. The findings refute notions that HIV is associated with higher CAD risk in Uganda and emphasize the need to ensure that the necessary work and research can be done to understand the greatest health threats for people with HIV regionally instead of relying on data from the Global North to make inferences about health priorities elsewhere.
Media contacts: For a PDF, please contact Angela Collom at acollom@acponline.org. To speak with corresponding author Mark J. Siedner, MD, MPH, please contact Noah Brown at nbrown9@partners.org, or Michael Morrison at mdmorrison@partners.org.
Journal
Annals of Internal Medicine
Method of Research
News article
Subject of Research
People
Article Title
Epidemiology of Coronary Atherosclerosis among People Living with HIV in Uganda: A Cross-Sectional Study
Article Publication Date
12-Mar-2025