Patho-immune Mechanisms of Hypertension in HIV: a Systematic and Thematic Review

Overview

Journal Curr Hypertens Rep

Specialty Cardiology & Vascular Diseases

Date 2019 Jun 6

PMID 31165257

Citations 37

Authors

Sepiso K Masenga

Benson M Hamooya

Selestine Nzala

Geoffrey Kwenda

Douglas C Heimburger

Wilbroad Mutale

Sody M Munsaka

John R Koethe

Annet Kirabo

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: To systematically review recent findings on the role of immune cell activation in the pathogenesis of hypertension in people living with HIV (PLWH) and compare studies from Sub-Saharan Africa with what is reported in the USA and European literature according to guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Recent Findings: PLWH have an increased risk for development of hypertension and cardiovascular disease. Chronic immune activation contributes to hypertension but the inflammatory milieu that predisposes PLWH to hypertension is poorly understood. We identified 45 relevant studies from 13 unique African countries. The prevalence of hypertension in PLWH on antiretroviral therapy (ART) and the ART-naive PLWH ranged from 6 to 50% and 2 to 41%, respectively. Interleukin (IL)-17A, interferon (IFN)-γ, and higher CD4 T cell counts were associated with hypertension in ART-treated participants. Targeting adaptive immune activation could provide improved care for hypertensive PLWH. Further research is needed to characterize the inflammatory milieu contributing to hypertension in PLWH especially in African populations where the global burden of HIV is the highest.

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