title: Cardiometabolic changes in treated versus never treated HIV-infected black South Africans: the PURE study.
abstract: BACKGROUND
  The use of antiretroviral treatment is known to be accompanied by several negative health outcomes and may negatively affect a country such as South Africa, which is the most burdened by the human immunodeficiency virus (HIV) in the world. We aimed to determine whether receiving antiretroviral treatment changes the cardiometabolic profile of HIV-infected South Africans.
  
  
  METHODS
  In this sub-study, embedded in the Prospective Urban and Rural Epidemiology (PURE) study, we compared the cardiometabolic profile in a cohort of 66 treated and 71 never treated HIV-infected participants from the North-West province, South Africa. By using standard techniques, these participants' cardiometabolic, biochemical and lifestyle variables were assessed in 2005 and 2010, respectively.
  
  
  RESULTS
  The treated group showed a higher percentage change in pulse pressure (13.3%; p = 0.004), systolic blood pressure (4.5%; p = 0.029) and CD4 cell count (9.2%; p = 0.009) levels over five years. During follow-up (2010), lipid variables were worse in the treated group. Further, antiretroviral treatment was associated with the percentage change in pulse pressure (R(2) = 0.24; β = 0.19; p = 0.020).
  
  
  CONCLUSIONS
  We concluded that Africans receiving antiretroviral treatment had a greater increase in pulse pressure and systolic blood pressure, as well as an unfavourable lipid profile when compared to never treated participants. Whether, in the long term, antiretroviral treatment will lead to increased arterial stiffness and/or accelerated atherosclerosis among this HIV-infected African population remains to be seen.
authors: Hypertension in Africa Research Team (HART), North-West University (Potchefstroom Campus), Potchefstroom, South Africa.
authors: Shani
authors: S
authors: Botha
authors: Hypertension in Africa Research Team (HART), North-West University (Potchefstroom Campus), Potchefstroom, South Africa. Electronic address: carla.fourie@nwu.ac.za.
authors: Carla M T
authors: CM
authors: Fourie
authors: Hypertension in Africa Research Team (HART), North-West University (Potchefstroom Campus), Potchefstroom, South Africa.
authors: Johannes M
authors: JM
authors: van Rooyen
authors: AUTHeR (Africa Unit for Transdisciplinary Health Research), Faculty of Health Science, North-West University, Potchefstroom, South Africa.
authors: Annamarie
authors: A
authors: Kruger
authors: Hypertension in Africa Research Team (HART), North-West University (Potchefstroom Campus), Potchefstroom, South Africa.
authors: Aletta E
authors: AE
authors: Schutte
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D050197:Atherosclerosis / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D044383:Black People; D001794:Blood Pressure / Q000187:drug effects*; D018791:CD4 Lymphocyte Count; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013019:South Africa / Q000453:epidemiology; D059289:Vascular Stiffness / Q000187:drug effects*
chemical_list: D044966:Anti-Retroviral Agents; D008055:Lipids
keywords: Antiretroviral therapy; Cardiometabolic profile; HIV-1; Pulse pressure; South Africa; Vascular stiffness