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Exergaming in Older People Living with HIV Improves Balance, Mobility and Ameliorates Some Aspects of Frailty
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Multiple substance use, inflammation and cardiac stretch in women living with HIV

Elise D Riley1, Jorge R Kizer2, Phyllis C Tien1

  • 1University of California, San Francisco, School of Medicine, Department of Medicine, Division of HIV, Infectious Diseases and Global Medicine, San Francisco, CA, USA.

Drug and Alcohol Dependence
|July 25, 2022
PubMed

Insights

Cardiovascular disease is high in women with HIV. Cannabis use was associated with lower cardiac stress biomarkers, suggesting potential protective effects despite polysubstance use and inflammation.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Toxicology

Background:

  • Cardiovascular disease (CVD) and heart failure (HF) prevalence is elevated in people with HIV (PWH), with sex-specific differences.
  • Drug use, common among low-income women with HIV (WLWH), exacerbates cardiac dysfunction.
  • Limited research explores the impact of drug use on CVD in WLWH.

Purpose of the Study:

  • To investigate the relationship between drug use, inflammation, and cardiac dysfunction in unsheltered and unstably housed WLWH.
  • To examine the effects of toxicology-confirmed drug use and inflammatory markers on NT-proBNP levels, a biomarker for cardiac stretch and HF.

Main Methods:

  • A six-month cohort study recruited 74 unsheltered/unstably housed WLWH in San Francisco.
  • Toxicology confirmed drug use and measured inflammatory markers (C-reactive protein, sCD14, sCD163, sTNFR2).
  • Adjusted analyses accounted for CVD risk factors, co-infections, medications, and menopause to assess NT-proBNP levels.

Main Results:

  • Participants (median age 53) had high rates of hypertension (72%) and substance use (tobacco 65%, cannabis 53%, cocaine 49%, methamphetamine 31%).
  • Cannabis use was associated with a 39.6% decrease in NT-proBNP levels.
  • sTNFR2, an inflammatory marker, was positively associated with NT-proBNP (65.5% increase).

Conclusions:

  • Among polysubstance-using WLWH, elevated NT-proBNP was linked to sTNFR2, but cannabis use was associated with 40% lower NT-proBNP levels.
  • Cannabis use may mitigate cardiac stress and dysfunction, independent of inflammation, in WLWH using multiple substances.
  • Further research is warranted to explore cannabis's cardiovascular protective pathways in this population.
Abstract

Keywords:
HIVInflammationNT-proBNPSTNFR2Womensubstance use

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