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Cardiometabolic health in people with HIV: expert consensus review
Rachel L Batterham1,2, Roger J Bedimo3,4, Ricardo S Diaz5
1UCL Division of Medicine, UCL School of Life and Medical Sciences, University College London, Gower Street, London WC1E 6BT, UK.
Insights
People with HIV face higher cardiometabolic risks. Expert consensus yielded recommendations for holistic care, including regular assessments and lifestyle advice to manage these health concerns.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- People with HIV (Human Immunodeficiency Virus) exhibit an elevated risk of cardiometabolic health issues compared to the general population.
- Antiretroviral therapy (ART) can influence cardiometabolic health, necessitating careful management.
- Existing knowledge gaps hinder optimal cardiometabolic health outcomes in individuals with HIV.
Purpose of the Study:
- To establish consensus data statements and clinical recommendations for improving cardiometabolic health in people with HIV.
- To provide expert guidance for healthcare professionals managing cardiometabolic risks in this population.
Main Methods:
- A comprehensive literature review of 281 sources (2016-2022) was performed.
- A modified Delphi method involving 16 international experts was employed.
- Consensus was reached through workshops and surveys to refine data statements and recommendations.
Main Results:
- Ten data statements were agreed upon, highlighting increased cardiometabolic risks and the impact of ART.
- Five significant data gaps were identified to guide future research.
- Fourteen clinical recommendations were developed, emphasizing a holistic care approach.
Conclusions:
- Expert consensus provides crucial guidance for managing cardiometabolic health in people with HIV.
- Recommendations focus on regular assessments, lifestyle counseling, and ART management.
- Addressing cardiometabolic risks is essential for comprehensive HIV care and improved patient outcomes.
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.
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