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Early Structural Cardiovascular Disease, HIV, and Tuberculosis in East Africa (ASANTE): Cross-sectional study

Saate S Shakil1,2, Sidney Korir3, Geoffrey Omondi3

  • 1Division of Cardiology, Department of Medicine, University of California Los Angeles, USA.

Medrxiv : the Preprint Server for Health Sciences
|April 1, 2025
PubMed

Insights

Persons living with HIV (PLWH) face increased cardiovascular disease risk. The ASANTE study in Kenya investigates atherosclerosis and myocardial dysfunction in PLWH, identifying key risk factors in this under-studied population.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Persons living with HIV (PLWH) exhibit a higher risk of cardiovascular disease (atherosclerosis, myocardial dysfunction) even with effective antiretroviral therapy (ART).
  • Sub-Saharan Africa, where most PLWH reside, lacks comprehensive data on HIV-related structural cardiovascular changes.
  • Understanding residual cardiovascular risk in PLWH is crucial for targeted interventions.

Purpose of the Study:

  • To determine the prevalence of subclinical coronary atherosclerosis and myocardial dysfunction in persons living with HIV in Nairobi, Kenya.
  • To identify traditional and non-traditional risk factors, including latent tuberculosis, associated with cardiovascular disease in this population.
  • To contribute novel data on HIV-associated cardiovascular disease phenotypes and risk factors from a high-burden region.

Main Methods:

  • The Early Structural Cardiovascular Disease, HIV, and Tuberculosis (ASANTE) study is a cross-sectional study in Nairobi, Kenya.
  • Enrollment of 400 participants (50% female, 50% PLWH) for multimodal cardiovascular phenotyping.
  • Utilizing coronary CT angiography (CCTA), echocardiography, and biological sample banking for comprehensive analysis.

Main Results:

  • Prevalence of subclinical coronary atherosclerosis will be assessed using CCTA.
  • Subclinical myocardial dysfunction will be evaluated via transthoracic echocardiography.
  • Analysis will encompass traditional cardiovascular risk factors and endemic infections like latent tuberculosis.

Conclusions:

  • The ASANTE study will provide critical insights into cardiovascular disease in PLWH in sub-Saharan Africa.
  • Findings will elucidate specific phenotypes and risk factors, informing future prevention and treatment strategies.
  • This research addresses a significant data gap in a vulnerable and under-studied population.
Abstract

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