e477cf09b18a5b2b618a34d9f0fe10a1 302143.pdf acbdf8cf749628d413ccbf9fe598fdb7ec8a4c9d 302143.pdf a0e623d6d5869f8f040aadd51801009a821aa2fa273cf9d233692678d207298d 302143.pdf Title: Cardiometabolic health in people with HIV: expert consensus review Subject: DOI: 10.1093/jac/dkae116; Journal of Antimicrobial Chemotherapy, 79, 6, 2024-04-24.; Abstract: Objectives: To develop consensus data statements and clinical recommendations to provide guidance for improving cardiometabolic health outcomes in people with HIV based on the knowledge and experience of an international panel of experts. Methods: A targeted literature review including 281 conference presentations, peer-reviewed articles, and background references on cardiometabolic health in adults with HIV published between January 2016 and April 2022 was conducted and used to develop draft consensus data statements. Using a modified Delphi method, an international panel of 16 experts convened in workshops and completed surveys to refine consensus data statements and generate clinical recommendations. Results: Overall, 10 data statements, five data gaps and 14 clinical recommendations achieved consensus. In the data statements, the panel describes increased risk of cardiometabolic health concerns in people with HIV compared with the general population, known risk factors, and the potential impact of antiretroviral therapy. The panel also identified data gaps to inform future research in people with HIV. Finally, in the clinical recommendations, the panel emphasizes the need for a holistic approach to comprehensive care that includes regular assessment of cardiometabolic health, access to cardiometabolic health services, counselling on potential changes in weight after initiating or switching antiretroviral therapy and encouraging a healthy lifestyle to lower cardiometabolic health risk. Conclusions: On the basis of available data and expert consensus, an international panel developed clinical recommendations to address the increased risk of cardiometabolic disorders in people with HIV to ensure appropriate cardiometabolic health management for this population. Keywords: Author: Rachel L. Batterham Creator: Servigistics Arbortext Advanced Print Publisher 11.1.4546/W-x64 Producer: PDFlib+PDI 9.0.7p3 (C++/Win64); modified using iTextSharp 4.1.6 by 1T3XT CreationDate: Wed May 29 10:22:33 2024 CEST ModDate: Fri Nov 8 11:59:06 2024 CET Custom Metadata: yes Metadata Stream: yes Tagged: yes UserProperties: no Suspects: no Form: AcroForm JavaScript: no Pages: 16 Encrypted: no Page size: 612.283 x 790.866 pts Page rot: 0 File size: 705793 bytes Optimized: no PDF version: 1.6 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- CAUQFJ+FSMe-Light Type 1C Custom yes yes yes 43 0 PHUGQU+FSMe-LightItalic Type 1C Custom yes yes yes 44 0 BRBYPP+FSMe-Bold Type 1C Custom yes yes yes 45 0 HVHFXS+ArialMT TrueType WinAnsi yes yes no 1 0 QDOIJW+FSMe-BoldItalic Type 1C Custom yes yes yes 40 0 LGNNOD+STIXGeneral-Regular Type 1C Custom yes yes yes 41 0 OZHQXU+FSMe Type 1C Custom yes yes yes 42 0 Times-Bold Type 1 Custom no no no 73 0 Times-Bold Type 1 Custom no no no 74 0 PBCMSX+MyriadPro-Regular Type 1 Custom yes yes no 75 0 Times-Roman Type 1 Custom no no no 76 0 Times-Roman Type 1 Custom no no no 68 0 Times-Bold Type 1 Custom no no no 69 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-11-12 02:44:21 CET RepresentationInformation: 302143.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-11-11 10:29:43 CET Size: 705793 Format: PDF Version: 1.6 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf Profile: Tagged PDF PDFMetadata: Objects: 2724 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: false CenterWindow: false DisplayDocTitle: true NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: OneColumn PageMode: UseOutlines Language: en Outlines: Item: Title: Cardiometabolic health in people with HIV: expert consensus review Children: Item: Title: Introduction Destination: secdkae116-s0 Item: Title: Methods Destination: secdkae116-s1 Children: Item: Title: Targeted literature review Destination: secdkae116-s1.1 Item: Title: Consensus process Destination: secdkae116-s1.2 Item: Title: Role of the study sponsor Destination: secdkae116-s1.3 Item: Title: Consensus statements Destination: secdkae116-s2 Children: Item: Title: Overview Destination: secdkae116-s2.1 Item: Title: Consensus data statements and summary of evidence Destination: secdkae116-s2.2 Item: Title: Weight change Destination: secdkae116-s2.3 Children: Item: Title: Overweight and obesity are major causes of worsened health globally and have become more prevalent over time in both people with HIV and the general population Destination: secdkae116-s2.3.1 Item: Title: Weight gain is expected in some people with HIV after antiretroviral therapy initiation, in part, due to a ‘return to health’ Destination: secdkae116-s2.3.2 Item: Title: Weight gain is more pronounced after initiation of tenofovir alafenamide and second-generation integrase strand transfer inhibitors when compared with older antiretroviral agents (mainly tenofovir disoproxil fumarate and efavirenz) Destination: secdkae116-s2.3.3 Item: Title: Demographic characteristics including female sex and, in US studies, black race have been associated with more pronounced weight gain thus far Destination: secdkae116-s2.3.4 Item: Title: Cardiovascular health Destination: secdkae116-s2.4 Children: Item: Title: Cardiovascular disease risk is higher in people with HIV compared with the general population Destination: secdkae116-s2.4.1 Item: Title: Traditional risk factors for cardiovascular disease apply to people with HIV Destination: secdkae116-s2.4.2 Item: Title: Untreated HIV and some antiretroviral agents (abacavir, ritonavir-boosted darunavir and lopinavir) have been associated with increased cardiovascular disease risk Destination: secdkae116-s2.4.3 Item: Title: Type 2 diabetes, insulin resistance, non-diabetic hyperglycaemia and metabolic-associated fatty liver disease Destination: secdkae116-s2.5 Children: Item: Title: Short-term data suggest that the prevalence of type 2 diabetes is similar or greater in people with HIV compared with individuals without HIV Destination: secdkae116-s2.5.1 Item: Title: Risk factors for insulin resistance and type 2 diabetes are multifactorial and include traditional and non-traditional factors Destination: secdkae116-s2.5.2 Item: Title: Metabolic-associated fatty liver disease is an important component of metabolic health in people with HIV Destination: secdkae116-s2.5.3 Item: Title: Male sex, physical inactivity, higher body mass index and type 2 diabetes have been identified as being associated with higher likelihood of hepatic steatosis and older age with higher likelihood of hepatic fibrosis Destination: secdkae116-s2.5.4 Item: Title: Bone health Destination: secdkae116-s2.6 Children: Item: Title: Abnormal bone health is a potential concern for all people with HIV: compared with individuals without HIV, people with HIV have greater bone loss as reflected by decreased bone mineral density and increased risk of fractures Destination: secdkae116-s2.6.1 Item: Title: Identified risk factors associated with reduced bone mineral density in people with HIV are traditional and HIV-specific Destination: secdkae116-s2.6.2 Item: Title: Initiating antiretroviral therapy is associated with decreases in bone mineral density regardless of antiretroviral therapy type Destination: secdkae116-s2.6.3 Item: Title: Vitamin D supplementation attenuates decreases in bone mineral density after antiretroviral therapy initiation Destination: secdkae116-s2.6.4 Item: Title: Compared with other antiretroviral agents, use of tenofovir disoproxil fumarate is associated with greater decreases in bone mineral density, which can be exacerbated by concomitant use of a boosted protease inhibitor Destination: secdkae116-s2.6.5 Item: Title: Switching from a regimen that includes tenofovir disoproxil fumarate to one that does not is associated with improved bone mineral density Destination: secdkae116-s2.6.6 Item: Title: Data gaps Destination: secdkae116-s2.7 Item: Title: Clinical recommendations Destination: secdkae116-s2.8 Children: Item: Title: General cardiometabolic care Destination: secdkae116-s2.8.1 Item: Title: Cardiometabolic health assessments Destination: secdkae116-s2.8.2 Item: Title: ART and cardiometabolic health Destination: secdkae116-s2.8.3 Item: Title: Cardiovascular health Destination: secdkae116-s2.8.4 Item: Title: Bone health Destination: secdkae116-s2.8.5 Item: Title: Discussion Destination: secdkae116-s3 Children: Item: Title: Conclusions Destination: secdkae116-s3.1 Item: Title: Acknowledgements Destination: acknow Item: Title: Funding Destination: secdkae116-s4 Item: Title: Transparency declarations Destination: secdkae116-s5 Item: Title: Supplementary data Destination: secdkae116-s6 Item: Title: References Destination: reflist Info: Title: Cardiometabolic health in people with HIV: expert consensus review Author: Rachel L. Batterham Subject: DOI: 10.1093/jac/dkae116; Journal of Antimicrobial Chemotherapy, 79, 6, 2024-04-24.; Abstract: Objectives: To develop consensus data statements and clinical recommendations to provide guidance for improving cardiometabolic health outcomes in people with HIV based on the knowledge and experience of an international panel of experts. Methods: A targeted literature review including 281 conference presentations, peer-reviewed articles, and background references on cardiometabolic health in adults with HIV published between January 2016 and April 2022 was conducted and used to develop draft consensus data statements. Using a modified Delphi method, an international panel of 16 experts convened in workshops and completed surveys to refine consensus data statements and generate clinical recommendations. Results: Overall, 10 data statements, five data gaps and 14 clinical recommendations achieved consensus. In the data statements, the panel describes increased risk of cardiometabolic health concerns in people with HIV compared with the general population, known risk factors, and the potential impact of antiretroviral therapy. The panel also identified data gaps to inform future research in people with HIV. Finally, in the clinical recommendations, the panel emphasizes the need for a holistic approach to comprehensive care that includes regular assessment of cardiometabolic health, access to cardiometabolic health services, counselling on potential changes in weight after initiating or switching antiretroviral therapy and encouraging a healthy lifestyle to lower cardiometabolic health risk. Conclusions: On the basis of available data and expert consensus, an international panel developed clinical recommendations to address the increased risk of cardiometabolic disorders in people with HIV to ensure appropriate cardiometabolic health management for this population. Keywords: Creator: Servigistics Arbortext Advanced Print Publisher 11.1.4546/W-x64 Producer: PDFlib+PDI 9.0.7p3 (C++/Win64); modified using iTextSharp 4.1.6 by 1T3XT CreationDate: Wed May 29 10:52:33 CEST 2024 ModDate: Fri Nov 08 11:59:06 CET 2024 ID: 0x14f1afd1654979756ccd0619ead81f12, 0xfbb72894e814ae6bb877cd1fecd4df11 Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: QDOIJW+FSMe-BoldItalic FontSubset: true FirstChar: 1 LastChar: 32 FontDescriptor: FontName: QDOIJW+FSMe-BoldItalic Flags: Nonsymbolic, Italic, ForceBold FontBBox: -151, -319, 1274, 1133 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: LGNNOD+STIXGeneral-Regular FontSubset: true FirstChar: 1 LastChar: 6 FontDescriptor: FontName: LGNNOD+STIXGeneral-Regular Flags: Nonsymbolic FontBBox: -995, -455, 2000, 1055 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: OZHQXU+FSMe FontSubset: true FirstChar: 1 LastChar: 3 FontDescriptor: FontName: OZHQXU+FSMe Flags: Nonsymbolic FontBBox: -84, -300, 1231, 1040 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: CAUQFJ+FSMe-Light FontSubset: true FirstChar: 1 LastChar: 96 FontDescriptor: FontName: CAUQFJ+FSMe-Light Flags: Nonsymbolic FontBBox: -82, -276, 1220, 1033 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: PHUGQU+FSMe-LightItalic FontSubset: true FirstChar: 1 LastChar: 78 FontDescriptor: FontName: PHUGQU+FSMe-LightItalic Flags: Nonsymbolic, Italic FontBBox: -148, -276, 1184, 1034 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: BRBYPP+FSMe-Bold FontSubset: true FirstChar: 1 LastChar: 66 FontDescriptor: FontName: BRBYPP+FSMe-Bold Flags: Nonsymbolic, ForceBold FontBBox: -80, -318, 1312, 1128 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true TrueType: Font: BaseFont: HVHFXS+ArialMT FontSubset: true FirstChar: 32 LastChar: 121 FontDescriptor: FontName: HVHFXS+ArialMT Flags: Nonsymbolic FontBBox: -664, -324, 2000, 1039 FontFile2: true Encoding: WinAnsiEncoding XMP: uuid:5ae3dde1-474d-4c45-ba45-31608e581b01 uuid:73B5AF9C-504D-9DEB-B8E8-B65DBDDCF537 True PDFlib+PDI 9.0.7p3 (C++/Win64); modified using iTextSharp 4.1.6 by 1T3XT application/pdf 10.1093/jac/dkae116 en Oxford University Press Cardiometabolic health in people with HIV: expert consensus review Rachel L. Batterham Roger J. Bedimo Ricardo S. Diaz Giovanni Guaraldi Janet Lo Esteban Martínez Grace A. McComsey Ana Milinkovic Toshio Naito Sebastian Noe Donal O’Shea Roger Paredes Jonathan M. Schapiro Mark S. Sulkowski François Venter Laura Waters Ilksen Ungan Yoruk Benjamin Young DOI: 10.1093/jac/dkae116; Journal of Antimicrobial Chemotherapy, 79, 6, 2024-04-24.; Abstract: Objectives: To develop consensus data statements and clinical recommendations to provide guidance for improving cardiometabolic health outcomes in people with HIV based on the knowledge and experience of an international panel of experts. Methods: A targeted literature review including 281 conference presentations, peer-reviewed articles, and background references on cardiometabolic health in adults with HIV published between January 2016 and April 2022 was conducted and used to develop draft consensus data statements. Using a modified Delphi method, an international panel of 16 experts convened in workshops and completed surveys to refine consensus data statements and generate clinical recommendations. Results: Overall, 10 data statements, five data gaps and 14 clinical recommendations achieved consensus. In the data statements, the panel describes increased risk of cardiometabolic health concerns in people with HIV compared with the general population, known risk factors, and the potential impact of antiretroviral therapy. The panel also identified data gaps to inform future research in people with HIV. Finally, in the clinical recommendations, the panel emphasizes the need for a holistic approach to comprehensive care that includes regular assessment of cardiometabolic health, access to cardiometabolic health services, counselling on potential changes in weight after initiating or switching antiretroviral therapy and encouraging a healthy lifestyle to lower cardiometabolic health risk. Conclusions: On the basis of available data and expert consensus, an international panel developed clinical recommendations to address the increased risk of cardiometabolic disorders in people with HIV to ensure appropriate cardiometabolic health management for this population. © The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. Journal Journal of Antimicrobial Chemotherapy © The Author(s) 2024. 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