Background: In African populations, estimated glomerular filtration rate by cystatin C (eGFRcys) is better aligned with gold-standard GFR measurements than eGFR by creatinine (eGFRcr). Moreover, eGFRcys is unaffected by the effects of antiretroviral therapy (ART) on tubular secretion and may thus provide better estimates of GFR in people with HIV on ART.
Setting: Observational cohort study of people of African ancestry living with suppressed HIV RNA on ART in London, United Kingdom.
Background: The increasing prevalence of dementia and new therapeutic developments for Alzheimer's disease (AD) have created an urgent need for rapid and cost-effective methods to diagnose those affected in the early stages of the disease. Unlike emergency departments, memory clinics lack triage systems, e.g.
View Article and Find Full Text PDFIntroduction: Depressive symptoms are highly prevalent among people with HIV, which can negatively impact HIV-related outcomes. We explore the cascade of mental healthcare for people with HIV experiencing depressive symptoms.
Methods: People with HIV who were part of the Pharmacokinetic and clinical Observations in PeoPle over fiftY (POPPY) study (2013-2016) were included.
Background: We aimed to provide insights into the effects of comorbidities on sleep health in people with HIV by assessing associations between multimorbidity patterns and sleep outcomes in the Pharmacokinetic and clinical Observations in PeoPle over fiftY (POPPY) sub-study.
Methods: Principal component analysis identified six multimorbidity patterns among participants with HIV (n = 1073) at baseline: Cardiovascular diseases (CVDs), Sexually transmitted diseases, Metabolic, Mental/Joint, Neurological and Cancer/Other. Burden z-scores were calculated for each individual/pattern.
Objectives: COVID-19 disproportionately affected people of Black ethnicities whilst also negatively affecting the health, wellbeing and livelihoods of people living with HIV. This may have been amplified by pre-existing socioeconomic marginalisation, poorer health, and structural racism. Despite being disproportionately affected by the pandemic, little is known about lived experiences of the COVID-19 pandemic within these communities.
View Article and Find Full Text PDFBackground: The spectrum of histological findings in transplanted kidneys from HIV-positive donors to HIV-positive recipients is relatively unexplored. This study describes the type and timing of histological diagnoses observed in this unique cohort.
Methods: Adequate biopsies were analyzed at implantation and posttransplant between September 2008 and May 2022.
Background: Apolipoprotein L1 (APOL1) high-risk variants are major determinants of chronic kidney disease (CKD) in people of African ancestry. Previous studies have identified epigenetic changes in relation to kidney function and CKD, but not in individuals with APOL1 high-risk genotypes. We conducted an epigenome-wide analysis of CKD and estimated glomerular filtration rate (eGFR) in in people of African ancestry and APOL1 high-risk genotypes with HIV.
View Article and Find Full Text PDFColorectal adenomas (CRAs) are potential precursor lesions to adenocarcinomas, currently classified by morphological features. We aimed to establish a molecular feature-based risk allocation framework toward improved patient stratification. Deep visual proteomics (DVP) is an approach that combines image-based artificial intelligence with automated microdissection and ultra-high sensitive mass spectrometry.
View Article and Find Full Text PDFObjectives: Our objective was to describe the prevalence of cardiovascular disease (CVD) risk factors in people of African ancestry with HIV in the UK.
Methods: We conducted a cross-sectional analysis of CVD risk factors in Black people with HIV aged ≥40 years and estimated the 10-year CVD risk using QRISK®3-2018. Correlations between body mass index (BMI) and CVD risk factors were described using Pearson correlation coefficients, and factors associated with 10-year CVD risk ≥5% were described using logistic regression.
Objective: The effect of atrial fibrillation (AF) patterns on outcomes remains controversial. This study aims to evaluate the influence of AF type on the risk of cardiocerebrovascular events after left atrial appendage closure (LAAC) at long-term follow-up.
Methods: AF was categorized as paroxysmal AF (PAF) and non-PAF (NPAF).
Objective: Metabolic dysfunction associated fatty liver disease (MAFLD) is over-represented in people with HIV (PWH). Maraviroc (MVC) and/or metformin (MET) may reduce MAFLD by influencing inflammatory pathways and fatty acid metabolism.
Design: Open-label, 48-week randomized trial with a 2 x 2 factorial design.
Background: People living with human immunodeficiency virus (HIV) are disproportionately impacted by socioeconomic deprivation and are at increased risk of developing other long-term conditions (LTCs). These illnesses require transformative action to tackle the adverse effects on their health. Data on lived experiences of LTCs among people living with HIV of Black African and Black Caribbean ethnicities are sparse, and how people with LTCs are impacted by social determinants of health (SDoH).
View Article and Find Full Text PDFObjectives: To describe HIV care outcomes in people of Black ethnicities living in England during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; coronavirus disease 2019 [COVID-19]) pandemic.
Methods: This was an observational cohort study of people of self-reported Black ethnicities attending for HIV care at nine HIV clinics across England. The primary outcome was a composite of antiretroviral therapy (ART) interruption and HIV viraemia (HIV RNA ≥200 copies/mL) ascertained via self-completed questionnaires and review of medical records.
Chest pain poses a diagnostic challenge in the emergency department and requires a thorough clinical assessment. The traditional distinction between "atypical" and "typical" chest pain carries the risk of not addressing nonischemic clinical pictures. The newly conceived subdivision into cardiac, possibly cardiac, and (probably) noncardiac causes of the presenting symptom complex addresses a much more interdisciplinary approach to a symptom-oriented diagnostic algorithm.
View Article and Find Full Text PDFBackground: There are no validated waist circumference (WC) cut-offs to define metabolic syndrome in Black people with HIV.
Methods: Cross-sectional analyses within the CKD-AFRICA study. We used Pearson correlation coefficients and receiver operating characteristic (ROC) curves to describe the relationship between WC and cardiometabolic parameters including triglycerides, cholesterol, glucose, glycated haemoglobin (HbA1c), and homeostatic model assessment for insulin resistance (HOMA-IR), and to identify optimal WC cut-offs for each of these outcomes.
Aims: Dolutegravir increases serum creatinine by inhibiting its renal tubular secretion and elimination. We investigated determinants of early changes in serum creatinine in a southern African cohort starting first-line dolutegravir-based antiretroviral therapy (ART).
Methods: We conducted a secondary analysis of data from participants in a randomized controlled trial of dolutegravir, emtricitabine and tenofovir disoproxil fumarate (TDF) or tenofovir alafenamide fumarate (TAF) (ADVANCE, NCT03122262).
Objective: Social determinants of health (SDH) are important determinants of long-term conditions and multimorbidity in the general population. The intersecting relationship between SDH and multimorbidity in people with HIV remains poorly studied.
Design: A cross-sectional study investigating the relationships between eight socio-economic parameters and prevalent comorbidities of clinical significance and multimorbidity in adults of African ancestry with HIV aged 18-65 years in South London, UK.
Background: Hepatic steatosis is a major cause of chronic liver disease associated with several negative health outcomes. We compared the prevalence of and factors associated with steatosis in people living with and without HIV.
Methods: Older (>50 years) and younger (<50 years) people with HIV and older HIV-negative controls (>50 years) underwent liver transient elastography examination with controlled attenuation parameter (steatosis ≥238 dB/m, moderate/severe steatosis ≥280 dB/m, liver fibrosis ≥7.