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Project

HIV-infection and air pollution as emerging cardiovascular risk factors in the Cape Town region: Are changes in the retinal microvasculature a biomarker of effect? (R-6623)

Background: According to the World Health Organisation (WHO), the leading global risk for mortality is high blood pressure and is responsible for 13% of deaths, whilst HIV/AIDS was reported as the world's sixth largest cause of death in 2004 (World Health Organisation, 2009). The introduction of HAART has not only modified the pathology of the HIV disease but has also increased the life expectancy of patients (Skowyra et al., 2012). However, the use of HAART has led to hitherto unrecognised complications such as vascular endothelial dysfunction and cardiovascular events (Skowyra et al., 2012). In addition, the American Heart Association published its first scientific statement associating air pollution with cardiovascular morbidity and mortality in 2004 (Brook et al., 2010). It is our view that, non-traditional cardiovascular risk factors such as HIV-infection, ART drugs, and air pollution must receive increased attention in sub-Saharan Africa, particularly South Africa (Skowyra et al., 2012). Aim: The aim of the proposed study is to investigate the effects of HIV-infection, ART drugs and air pollution exposure as emerging cardiovascular risk factors on endothelial function in adult human subjects, using non-invasive diagnostic techniques. Study design and Ethics: The proposed study is a sub-study of a large, multi-centre, multi-national study called EndoAfrica (Health Ethics Research Committee of Stellenbosch University, Reference No: N13/05/064). The proposed study is a longitudinal cohort study with participants sampled from populations of the Western Cape Province in South Africa. For the purposes of the PhD study, four groups of (50-150 participants) are envisaged: (1) HIV-negative control participants (air pollution measurements will also be performed on this group), (2) HIV-positive participants not on ART, (3) HIV-positive participants on ART for 2 years or more, and (4) HIV-positive participants who are about to commence or have been on ART for 1 month or less. Exclusion criteria: Age: 18 years or less; pregnant; 3 months or less post-partum; terminally ill; HIV-positive participants on second line ART. Methods: (i) retinal microvascular imaging and analysis; (ii) Air pollution exposure monitoring and analysis; (iii) health questionnaire; (iv) anthropometric measurements; (v) blood chemical pathology and vascular biomarker measurements. Potential impact of outcomes: The research outcomes will provide clarification as to whether HIV, ART drugs and air pollution exposure are independent endothelial function risk factors. In addition, a strong correlation between the endothelial function measurement data, cardiovascular disease outcomes, and the retinal microvascular image analysis results, will have a significant impact as it will be suggestive of retinal imaging as a non-invasive technique that may be used to detect endothelial dysfunction.
Date:1 Jan 2016 →  31 Dec 2019
Keywords:CELLULAR AND MOLECULAR ASPECTS OF TOXICITY
Disciplines:General biology, Plant biology