Sepiso K . Masenga | Mulungushi University (original) (raw)

Papers by Sepiso K . Masenga

Research paper thumbnail of Glycocalyx–Sodium Interaction in Vascular Endothelium

Nutrients

The glycocalyx generally covers almost all cellular surfaces, where it participates in mediating ... more The glycocalyx generally covers almost all cellular surfaces, where it participates in mediating cell-surface interactions with the extracellular matrix as well as with intracellular signaling molecules. The endothelial glycocalyx that covers the luminal surface mediates the interactions of endothelial cells with materials flowing in the circulating blood, including blood cells. Cardiovascular diseases (CVD) remain a major cause of morbidity and mortality around the world. The cardiovascular risk factors start by causing endothelial cell dysfunction associated with destruction or irregular maintenance of the glycocalyx, which may culminate into a full-blown cardiovascular disease. The endothelial glycocalyx plays a crucial role in shielding the cell from excessive exposure and absorption of excessive salt, which can potentially cause damage to the endothelial cells and underlying tissues of the blood vessels. So, in this mini review/commentary, we delineate and provide a concise sum...

Research paper thumbnail of Reach and uptake of mass drug administration for worm infections through health facility, school, and community-based approaches in two districts of Zambia: a call for scale-up

Epidemiology and Infection

Soil-transmitted helminthiases and schistosomiasis cause significant physical, mental, and nutrit... more Soil-transmitted helminthiases and schistosomiasis cause significant physical, mental, and nutritional deficiencies, especially among children. Health facility, school, and community-based mass drug administration of anthelminthic drugs targeting children have been rolled out with significant results to counter these effects. This study assessed the factors associated with treatment coverage among children of Mazabuka and Siavonga districts of Zambia. In 2016, we conducted a cross-sectional survey of 1,416 children. Demographic and treatment data were collected using a structured questionnaire. Data were analyzed using Stata version 15. The statistical methods used were chi-square test and multilevel mixed-effect model. The study comprised 1,416 participants of whom 51.5% (n=695) were males and 48.5% (n=654) females. About half (52.7%, n=746) were school-age and 47.3% (n=670) preschool children. Overall treatment coverage was 53.7% (n=761, 95% confidence interval (CI) 51.1, 56.4). A greater proportion of preschool-age children were treated compared with school-age ones, 65.2% vs. 43.4%, p<0.001. Similarly, a greater proportion of school-age and preschool-age children in the Community-directed treatment intervention group were treated than in the regular mass drug administration group (school-age; 77.2% vs. 56.6%, p<0.001, preschool 53.1% vs. 45.5%, p=0.061). The factors significantly associated with treatment among school-age participants were being male (adjusted odds ratio (AOR) 1.83, 95%CI 1.23-2.72), integrated Community Directed Treatment intervention (AOR 5.53; 95%CI 3.41-8.97), and long distance to the health facility (AOR 2.20; 95%CI 1.36-3.56). Among preschool-aged participants, the factors associated with treatment were being in Siavonga district (AOR 0.03; 95%CI 0.01-0.04) and long distance to the health facility (AOR 0.35; 95%CI 0.21-0.59). The treatment coverage among children of Mazabuka and Siavonga districts was influenced by location, sex, distance to the health facility, and treatment approach. Therefore, there is a need to enhance mass drug administration by optimizing community-directed treatment to increase the uptake of helminth and schistosomiasis treatment especially

Research paper thumbnail of Hypertensive heart disease: risk factors, complications and mechanisms

Frontiers in Cardiovascular Medicine

Hypertensive heart disease constitutes functional and structural dysfunction and pathogenesis occ... more Hypertensive heart disease constitutes functional and structural dysfunction and pathogenesis occurring primarily in the left ventricle, the left atrium and the coronary arteries due to chronic uncontrolled hypertension. Hypertensive heart disease is underreported and the mechanisms underlying its correlates and complications are not well elaborated. In this review, we summarize the current understanding of hypertensive heart disease, we discuss in detail the mechanisms associated with development and complications of hypertensive heart disease especially left ventricular hypertrophy, atrial fibrillation, heart failure and coronary artery disease. We also briefly highlight the role of dietary salt, immunity and genetic predisposition in hypertensive heart disease pathogenesis.

Research paper thumbnail of Cardiovascular outcomes among persons with HIV and nonalcoholic fatty liver disease

Research paper thumbnail of Salt and Gut Microbiota in Heart Failure

Current Hypertension Reports

Research paper thumbnail of HIV–Host Cell Interactions

Cells

The development of antiretroviral drugs (ARVs) was a great milestone in the management of HIV inf... more The development of antiretroviral drugs (ARVs) was a great milestone in the management of HIV infection. ARVs suppress viral activity in the host cell, thus minimizing injury to the cells and prolonging life. However, an effective treatment has remained elusive for four decades due to the successful immune evasion mechanisms of the virus. A thorough understanding of the molecular interaction of HIV with the host cell is essential in the development of both preventive and curative therapies for HIV infection. This review highlights several inherent mechanisms of HIV that promote its survival and propagation, such as the targeting of CD4+ lymphocytes, the downregulation of MHC class I and II, antigenic variation and an envelope complex that minimizes antibody access, and how they collaboratively render the immune system unable to mount an effective response.

Research paper thumbnail of Mechanisms of Oxidative Stress in Metabolic Syndrome

International Journal of Molecular Sciences

Metabolic syndrome is a cluster of conditions associated with the risk of diabetes mellitus type ... more Metabolic syndrome is a cluster of conditions associated with the risk of diabetes mellitus type 2 and cardiovascular diseases (CVDs). Metabolic syndrome is closely related to obesity. Increased adiposity promotes inflammation and oxidative stress, which are precursors of various complications involving metabolic syndrome components, namely insulin resistance, hypertension, and hyperlipidemia. An increasing number of studies confirm the importance of oxidative stress and chronic inflammation in the etiology of metabolic syndrome. However, few studies have reviewed the mechanisms underlying the role of oxidative stress in contributing to metabolic syndrome. In this review, we highlight mechanisms by which reactive oxygen species (ROS) increase mitochondrial dysfunction, protein damage, lipid peroxidation, and impair antioxidant function in metabolic syndrome. Biomarkers of oxidative stress can be used in disease diagnosis and evaluation of severity.

Research paper thumbnail of The epithelial sodium channel in inflammation and blood pressure modulation

Frontiers in Cardiovascular Medicine

A major regulator of blood pressure and volume homeostasis in the kidney is the epithelial sodium... more A major regulator of blood pressure and volume homeostasis in the kidney is the epithelial sodium channel (ENaC). ENaC is composed of alpha(α)/beta(β)/gamma(γ) or delta(δ)/beta(β)/gamma(γ) subunits. The δ subunit is functional in the guinea pig, but not in routinely used experimental rodent models including rat or mouse, and thus remains the least understood of the four subunits. While the δ subunit is poorly expressed in the human kidney, we recently found that its gene variants are associated with blood pressure and kidney function. The δ subunit is expressed in the human vasculature where it may influence vascular function. Moreover, we recently found that the δ subunit is also expressed human antigen presenting cells (APCs). Our studies indicate that extracellular Na+ enters APCs via ENaC leading to inflammation and salt-induced hypertension. In this review, we highlight recent findings on the role of extra-renal ENaC in inflammation, vascular dysfunction, and blood pressure mod...

Research paper thumbnail of Salt Taste and Salt Sensitive Hypertension in HIV

Current Hypertension Reports

Research paper thumbnail of The Value of Procalcitonin and C-reactive protein as early markers of Bacteraemia among patients with Haematological Malignancies receiving Chemotherapy: a cross-sectional study

Medical Journal of Zambia

Background: The immune system of patients with haematological malignancies is suppressed during c... more Background: The immune system of patients with haematological malignancies is suppressed during chemotherapy. This renders them vulnerable to frequent infections especially of the bacterial type. Timely diagnosis of these infections is difficult, because a severe infection may be asymptomatic or manifest only in the form of fever or malaise. There is need for laboratory markers that can detect an infectious process at an early stage. This study was aimed at determining the value of using Procalcitonin (PCT) and C reactive protein (CRP), for early diagnosis of infection in patients with haematological malignancies receiving chemotherapy. Methods: This was a cross sectional study consisting of sixty eight (68) patients with haematological malignancies. Data from each participant including sex, age, clinical and laboratory data were collected after obtaining informed consent. Blood specimens were then collected for measurement of PCT, CRP and bacteriological analysis. Patients were div...

Research paper thumbnail of Plasma osteopontin in persons with HIV and the risk for cardiovascular disease

Research paper thumbnail of T-Lymphocytes predict metabolic syndrome among people with HIV in Zambia

Annals of Epidemiology, Nov 1, 2022

Research paper thumbnail of Sex differences in hypertension among people living with HIV after initiation of antiretroviral therapy

Frontiers in Cardiovascular Medicine

BackgroundHypertension is common in people living with HIV (PLWH) on antiretroviral therapy (ART)... more BackgroundHypertension is common in people living with HIV (PLWH) on antiretroviral therapy (ART). In the general population and in experimental animal models, the incidence of hypertension is greater in males than in females, especially during the premenopausal period. However, it is not known whether there are sex differences in hypertension associated with HIV and ART, and the factors contributing to incident hypertension among PLWH have not been well characterized. In this study, we aimed to determine the time course, sex differences and factors associated with incident hypertension in PLWH initiating ART.Methods and resultsWe conducted a retrospective study in which we used programmatic data from the ART registry to identify sex differences in the determinants of incident hypertension among PLWH initiating the ART regimen from Livingstone University Teaching Hospital in Zambia and followed for 8 years. Males developed hypertension earlier, 2 years after initiating ART, compared...

Research paper thumbnail of Subclinical cardiac disease in children with perinatally acquired HIV is associated with inflammation

Research paper thumbnail of Immediate pressor response to oral salt and its assessment in the clinic: a time series clinical trial

Clinical Hypertension

Background High blood pressure (BP) is associated with high-salt consumption especially in sub-Sa... more Background High blood pressure (BP) is associated with high-salt consumption especially in sub-Saharan Africa. Although the pressor effect of salt is viewed as a chronic effect, some studies suggest that a salty meal may increase BP immediately in some individuals, and that this effect may cause endothelial dysfunction. Therefore, the aim of our research was to study the immediate pressor response to oral salt (IPROS) and its determinants, with the expectation that a simple methodology may be devised to diagnose it in the clinic or in low-resource environments. Methods We conducted a time series trial at Livingstone Central Hospital. We present data in 127 normotensive participants who ingested 2 g of sodium chloride; their BP was monitored for 120 minutes in intervals of 10 minutes. Sociodemographic and clinical data were collected. Descriptive and inferential statistics were used for analyses of data. Results Median age was 30 years (interquartile range, 22–46 years) and 52% were ...

Research paper thumbnail of Sox6, A Potential Target for MicroRNAs in Cardiometabolic Disease

Current Hypertension Reports

Purpose of Review The study aims to review recent advances in knowledge on the interplay between ... more Purpose of Review The study aims to review recent advances in knowledge on the interplay between miRNAs and the s ex-determining Region Y (SRY)-related high-mobility-group box 6 (Sox6) in physiology and pathophysiology, highlighting an important role in autoimmune and cardiometabolic conditions. Recent Findings The transcription factor Sox6 is an important member of the SoxD family and plays an indispensable role in adult tissue homeostasis, regeneration, and physiology. Abnormal expression of the Sox6 gene has been implicated in several disease conditions including diabetes, cardiomyopathy, autoimmune diseases, and hypertension. Expression of Sox6 is regulated by miRNAs, which are RNAs of about 22 nucleotides, and have also been implicated in several pathophysiological conditions where Sox6 plays a role. Summary Regulation of Sox6 by miRNAs is important in diverse physiological tissues and organs. Dysregulation of the interplay between miRNAs and Sox6 is an important determinant of various disease conditions and may be actionable for therapeutic purposes.

Research paper thumbnail of A “Return to Health” Is Associated With Blood Pressure Increase After a Year of Antiretroviral Therapy in People With HIV

American Journal of Hypertension

Research paper thumbnail of Metabolic syndrome in Zambian adults with human immunodeficiency virus on antiretroviral therapy

Medicine

Abstract Metabolic syndrome (MetS) is a constellation of factors including hypertension, abdomina... more Abstract Metabolic syndrome (MetS) is a constellation of factors including hypertension, abdominal obesity, dyslipidemia, and insulin resistance that separately and together significantly increase risk for cardiovascular disease (CVD) and diabetes. In sub-Saharan Africa, with a substantial burden of human immunodeficiency virus (HIV) and increasing prevalence of CVD and diabetes, there is a paucity of epidemiological data on demographic, laboratory, and clinical characteristics associated with MetS among people with HIV (people with human [PWH]). Therefore, this study aimed to determine the burden and factors influencing MetS in antiretroviral therapy (ART)-experienced individuals in Zambia. We collected cross-sectional demographic, lifestyle, anthropometric, clinical, and laboratory data in a cohort of ART-experienced (on ART for ≥6 months) adults in 24 urban HIV treatment clinics of Zambia between August, 2016 and May, 2020. MetS was defined as having ≥3 of the following characteristics: low high density lipoprotein cholesterol (HDL-c) (<1.0 mmol/L for men, <1.3 for women), elevated waist circumference (≥94 cm for men, ≥80 cm for women), elevated triglycerides (≥1.7 mmol/L), elevated fasting blood glucose (≥5.6 mmol/L), and elevated blood pressure (BP) (systolic BP ≥130 or diastolic BP ≥85 mm Hg). Virological failure (VF) was defined as HIV viral load ≥1000 copies/mL. The following statistical methods were used: Chi-square test, Wilcoxon rank-sum test, and multivariable logistic regression. Among 1108 participants, the median age (interquartile range [IQR]) was 41 years (34, 49); 666 (60.1%) were females. The prevalence of MetS was 26.3% (95% confidence interval [CI] 23.9–29.1). Age (adjusted odds ratio [OR] 1.07; 95% CI 1.04–1.11), female sex (OR 3.02; 95% CI 1.55–5.91), VF (OR 1.98; 95% CI 1.01–3.87), dolutegravir (DTG)-based regimen (OR 2.10; 95% CI 1.05–4.20), hip-circumference (OR 1.03; 95% CI 1.01–1.05), T-lymphocyte count (OR 2.23; 95% CI 1.44–3.43), high-sensitivity C-reactive protein (hsCRP) (OR 1.14; 95% CI 1.01–1.29), and fasting insulin (OR 1.02; 95% CI 1.01–1.04) were significantly associated with MetS. Metabolic syndrome was highly prevalent among HIV+ adults receiving ART in Zambia and associated with demographic, clinical, anthropometric, and inflammatory characteristics. The association between MetS and dolutegravir requires further investigation, as does elucidation of the impact of MetS on ART outcomes in sub-Saharan African PWH.

Research paper thumbnail of Correlates of Hypertension among Persons Living with HIV at Livingstone Central Hospital: A Crosssectional study

Medical Journal of Zambia

Background: Persons living with HIV (PLWH) are more likely to develop hypertension and cardiovasc... more Background: Persons living with HIV (PLWH) are more likely to develop hypertension and cardiovascular disease than the HIV-negative population. The new hypertension guidelines by the American Heart Association (AHA) and the American College of Cardiology (ACC) lowered the definition of hypertension from systolic and diastolic blood pressure (BP) of ≥ 140/90mmHg to ≥ 130/80, respectively. This study was aimed at determining the prevalence and factors associated with hypertension in PLWH in Livingstone using the new hypertension diagnostic criteria. Methods: This was a cross-sectional study. We recruited 226 antiretroviral treated PLWH attending routine visits. Socio-demographic, health and clinical data including BP readings were collected. Interviewer-structured questionnaires adapted from the World Health Organization Stepwise approach to Surveillance ( WHO STEPs) and the international physical activity questionnaire (IPAQ) were used to collect data. Statistical evaluations were em...

Research paper thumbnail of Recent advances in modulation of cardiovascular diseases by the gut microbiota

Journal of Human Hypertension

The gut microbiota has recently gained attention due to its association with cardiovascular healt... more The gut microbiota has recently gained attention due to its association with cardiovascular health, cancers, gastrointestinal disorders, and non-communicable diseases. One critical question is how the composition of the microbiota contributes to cardiovascular diseases (CVDs). Insightful reviews on the gut microbiota, its metabolites and the mechanisms that underlie its contribution to CVD are limited. Hence, the aim of this review was to describe linkages between the composition of the microbiota and CVD, CVD risk factors such as hypertension, diet, ageing, and sex differences. We have also highlighted potential therapies for improving the composition of the gut microbiota, which may result in better cardiovascular health.

Research paper thumbnail of Glycocalyx–Sodium Interaction in Vascular Endothelium

Nutrients

The glycocalyx generally covers almost all cellular surfaces, where it participates in mediating ... more The glycocalyx generally covers almost all cellular surfaces, where it participates in mediating cell-surface interactions with the extracellular matrix as well as with intracellular signaling molecules. The endothelial glycocalyx that covers the luminal surface mediates the interactions of endothelial cells with materials flowing in the circulating blood, including blood cells. Cardiovascular diseases (CVD) remain a major cause of morbidity and mortality around the world. The cardiovascular risk factors start by causing endothelial cell dysfunction associated with destruction or irregular maintenance of the glycocalyx, which may culminate into a full-blown cardiovascular disease. The endothelial glycocalyx plays a crucial role in shielding the cell from excessive exposure and absorption of excessive salt, which can potentially cause damage to the endothelial cells and underlying tissues of the blood vessels. So, in this mini review/commentary, we delineate and provide a concise sum...

Research paper thumbnail of Reach and uptake of mass drug administration for worm infections through health facility, school, and community-based approaches in two districts of Zambia: a call for scale-up

Epidemiology and Infection

Soil-transmitted helminthiases and schistosomiasis cause significant physical, mental, and nutrit... more Soil-transmitted helminthiases and schistosomiasis cause significant physical, mental, and nutritional deficiencies, especially among children. Health facility, school, and community-based mass drug administration of anthelminthic drugs targeting children have been rolled out with significant results to counter these effects. This study assessed the factors associated with treatment coverage among children of Mazabuka and Siavonga districts of Zambia. In 2016, we conducted a cross-sectional survey of 1,416 children. Demographic and treatment data were collected using a structured questionnaire. Data were analyzed using Stata version 15. The statistical methods used were chi-square test and multilevel mixed-effect model. The study comprised 1,416 participants of whom 51.5% (n=695) were males and 48.5% (n=654) females. About half (52.7%, n=746) were school-age and 47.3% (n=670) preschool children. Overall treatment coverage was 53.7% (n=761, 95% confidence interval (CI) 51.1, 56.4). A greater proportion of preschool-age children were treated compared with school-age ones, 65.2% vs. 43.4%, p<0.001. Similarly, a greater proportion of school-age and preschool-age children in the Community-directed treatment intervention group were treated than in the regular mass drug administration group (school-age; 77.2% vs. 56.6%, p<0.001, preschool 53.1% vs. 45.5%, p=0.061). The factors significantly associated with treatment among school-age participants were being male (adjusted odds ratio (AOR) 1.83, 95%CI 1.23-2.72), integrated Community Directed Treatment intervention (AOR 5.53; 95%CI 3.41-8.97), and long distance to the health facility (AOR 2.20; 95%CI 1.36-3.56). Among preschool-aged participants, the factors associated with treatment were being in Siavonga district (AOR 0.03; 95%CI 0.01-0.04) and long distance to the health facility (AOR 0.35; 95%CI 0.21-0.59). The treatment coverage among children of Mazabuka and Siavonga districts was influenced by location, sex, distance to the health facility, and treatment approach. Therefore, there is a need to enhance mass drug administration by optimizing community-directed treatment to increase the uptake of helminth and schistosomiasis treatment especially

Research paper thumbnail of Hypertensive heart disease: risk factors, complications and mechanisms

Frontiers in Cardiovascular Medicine

Hypertensive heart disease constitutes functional and structural dysfunction and pathogenesis occ... more Hypertensive heart disease constitutes functional and structural dysfunction and pathogenesis occurring primarily in the left ventricle, the left atrium and the coronary arteries due to chronic uncontrolled hypertension. Hypertensive heart disease is underreported and the mechanisms underlying its correlates and complications are not well elaborated. In this review, we summarize the current understanding of hypertensive heart disease, we discuss in detail the mechanisms associated with development and complications of hypertensive heart disease especially left ventricular hypertrophy, atrial fibrillation, heart failure and coronary artery disease. We also briefly highlight the role of dietary salt, immunity and genetic predisposition in hypertensive heart disease pathogenesis.

Research paper thumbnail of Cardiovascular outcomes among persons with HIV and nonalcoholic fatty liver disease

Research paper thumbnail of Salt and Gut Microbiota in Heart Failure

Current Hypertension Reports

Research paper thumbnail of HIV–Host Cell Interactions

Cells

The development of antiretroviral drugs (ARVs) was a great milestone in the management of HIV inf... more The development of antiretroviral drugs (ARVs) was a great milestone in the management of HIV infection. ARVs suppress viral activity in the host cell, thus minimizing injury to the cells and prolonging life. However, an effective treatment has remained elusive for four decades due to the successful immune evasion mechanisms of the virus. A thorough understanding of the molecular interaction of HIV with the host cell is essential in the development of both preventive and curative therapies for HIV infection. This review highlights several inherent mechanisms of HIV that promote its survival and propagation, such as the targeting of CD4+ lymphocytes, the downregulation of MHC class I and II, antigenic variation and an envelope complex that minimizes antibody access, and how they collaboratively render the immune system unable to mount an effective response.

Research paper thumbnail of Mechanisms of Oxidative Stress in Metabolic Syndrome

International Journal of Molecular Sciences

Metabolic syndrome is a cluster of conditions associated with the risk of diabetes mellitus type ... more Metabolic syndrome is a cluster of conditions associated with the risk of diabetes mellitus type 2 and cardiovascular diseases (CVDs). Metabolic syndrome is closely related to obesity. Increased adiposity promotes inflammation and oxidative stress, which are precursors of various complications involving metabolic syndrome components, namely insulin resistance, hypertension, and hyperlipidemia. An increasing number of studies confirm the importance of oxidative stress and chronic inflammation in the etiology of metabolic syndrome. However, few studies have reviewed the mechanisms underlying the role of oxidative stress in contributing to metabolic syndrome. In this review, we highlight mechanisms by which reactive oxygen species (ROS) increase mitochondrial dysfunction, protein damage, lipid peroxidation, and impair antioxidant function in metabolic syndrome. Biomarkers of oxidative stress can be used in disease diagnosis and evaluation of severity.

Research paper thumbnail of The epithelial sodium channel in inflammation and blood pressure modulation

Frontiers in Cardiovascular Medicine

A major regulator of blood pressure and volume homeostasis in the kidney is the epithelial sodium... more A major regulator of blood pressure and volume homeostasis in the kidney is the epithelial sodium channel (ENaC). ENaC is composed of alpha(α)/beta(β)/gamma(γ) or delta(δ)/beta(β)/gamma(γ) subunits. The δ subunit is functional in the guinea pig, but not in routinely used experimental rodent models including rat or mouse, and thus remains the least understood of the four subunits. While the δ subunit is poorly expressed in the human kidney, we recently found that its gene variants are associated with blood pressure and kidney function. The δ subunit is expressed in the human vasculature where it may influence vascular function. Moreover, we recently found that the δ subunit is also expressed human antigen presenting cells (APCs). Our studies indicate that extracellular Na+ enters APCs via ENaC leading to inflammation and salt-induced hypertension. In this review, we highlight recent findings on the role of extra-renal ENaC in inflammation, vascular dysfunction, and blood pressure mod...

Research paper thumbnail of Salt Taste and Salt Sensitive Hypertension in HIV

Current Hypertension Reports

Research paper thumbnail of The Value of Procalcitonin and C-reactive protein as early markers of Bacteraemia among patients with Haematological Malignancies receiving Chemotherapy: a cross-sectional study

Medical Journal of Zambia

Background: The immune system of patients with haematological malignancies is suppressed during c... more Background: The immune system of patients with haematological malignancies is suppressed during chemotherapy. This renders them vulnerable to frequent infections especially of the bacterial type. Timely diagnosis of these infections is difficult, because a severe infection may be asymptomatic or manifest only in the form of fever or malaise. There is need for laboratory markers that can detect an infectious process at an early stage. This study was aimed at determining the value of using Procalcitonin (PCT) and C reactive protein (CRP), for early diagnosis of infection in patients with haematological malignancies receiving chemotherapy. Methods: This was a cross sectional study consisting of sixty eight (68) patients with haematological malignancies. Data from each participant including sex, age, clinical and laboratory data were collected after obtaining informed consent. Blood specimens were then collected for measurement of PCT, CRP and bacteriological analysis. Patients were div...

Research paper thumbnail of Plasma osteopontin in persons with HIV and the risk for cardiovascular disease

Research paper thumbnail of T-Lymphocytes predict metabolic syndrome among people with HIV in Zambia

Annals of Epidemiology, Nov 1, 2022

Research paper thumbnail of Sex differences in hypertension among people living with HIV after initiation of antiretroviral therapy

Frontiers in Cardiovascular Medicine

BackgroundHypertension is common in people living with HIV (PLWH) on antiretroviral therapy (ART)... more BackgroundHypertension is common in people living with HIV (PLWH) on antiretroviral therapy (ART). In the general population and in experimental animal models, the incidence of hypertension is greater in males than in females, especially during the premenopausal period. However, it is not known whether there are sex differences in hypertension associated with HIV and ART, and the factors contributing to incident hypertension among PLWH have not been well characterized. In this study, we aimed to determine the time course, sex differences and factors associated with incident hypertension in PLWH initiating ART.Methods and resultsWe conducted a retrospective study in which we used programmatic data from the ART registry to identify sex differences in the determinants of incident hypertension among PLWH initiating the ART regimen from Livingstone University Teaching Hospital in Zambia and followed for 8 years. Males developed hypertension earlier, 2 years after initiating ART, compared...

Research paper thumbnail of Subclinical cardiac disease in children with perinatally acquired HIV is associated with inflammation

Research paper thumbnail of Immediate pressor response to oral salt and its assessment in the clinic: a time series clinical trial

Clinical Hypertension

Background High blood pressure (BP) is associated with high-salt consumption especially in sub-Sa... more Background High blood pressure (BP) is associated with high-salt consumption especially in sub-Saharan Africa. Although the pressor effect of salt is viewed as a chronic effect, some studies suggest that a salty meal may increase BP immediately in some individuals, and that this effect may cause endothelial dysfunction. Therefore, the aim of our research was to study the immediate pressor response to oral salt (IPROS) and its determinants, with the expectation that a simple methodology may be devised to diagnose it in the clinic or in low-resource environments. Methods We conducted a time series trial at Livingstone Central Hospital. We present data in 127 normotensive participants who ingested 2 g of sodium chloride; their BP was monitored for 120 minutes in intervals of 10 minutes. Sociodemographic and clinical data were collected. Descriptive and inferential statistics were used for analyses of data. Results Median age was 30 years (interquartile range, 22–46 years) and 52% were ...

Research paper thumbnail of Sox6, A Potential Target for MicroRNAs in Cardiometabolic Disease

Current Hypertension Reports

Purpose of Review The study aims to review recent advances in knowledge on the interplay between ... more Purpose of Review The study aims to review recent advances in knowledge on the interplay between miRNAs and the s ex-determining Region Y (SRY)-related high-mobility-group box 6 (Sox6) in physiology and pathophysiology, highlighting an important role in autoimmune and cardiometabolic conditions. Recent Findings The transcription factor Sox6 is an important member of the SoxD family and plays an indispensable role in adult tissue homeostasis, regeneration, and physiology. Abnormal expression of the Sox6 gene has been implicated in several disease conditions including diabetes, cardiomyopathy, autoimmune diseases, and hypertension. Expression of Sox6 is regulated by miRNAs, which are RNAs of about 22 nucleotides, and have also been implicated in several pathophysiological conditions where Sox6 plays a role. Summary Regulation of Sox6 by miRNAs is important in diverse physiological tissues and organs. Dysregulation of the interplay between miRNAs and Sox6 is an important determinant of various disease conditions and may be actionable for therapeutic purposes.

Research paper thumbnail of A “Return to Health” Is Associated With Blood Pressure Increase After a Year of Antiretroviral Therapy in People With HIV

American Journal of Hypertension

Research paper thumbnail of Metabolic syndrome in Zambian adults with human immunodeficiency virus on antiretroviral therapy

Medicine

Abstract Metabolic syndrome (MetS) is a constellation of factors including hypertension, abdomina... more Abstract Metabolic syndrome (MetS) is a constellation of factors including hypertension, abdominal obesity, dyslipidemia, and insulin resistance that separately and together significantly increase risk for cardiovascular disease (CVD) and diabetes. In sub-Saharan Africa, with a substantial burden of human immunodeficiency virus (HIV) and increasing prevalence of CVD and diabetes, there is a paucity of epidemiological data on demographic, laboratory, and clinical characteristics associated with MetS among people with HIV (people with human [PWH]). Therefore, this study aimed to determine the burden and factors influencing MetS in antiretroviral therapy (ART)-experienced individuals in Zambia. We collected cross-sectional demographic, lifestyle, anthropometric, clinical, and laboratory data in a cohort of ART-experienced (on ART for ≥6 months) adults in 24 urban HIV treatment clinics of Zambia between August, 2016 and May, 2020. MetS was defined as having ≥3 of the following characteristics: low high density lipoprotein cholesterol (HDL-c) (<1.0 mmol/L for men, <1.3 for women), elevated waist circumference (≥94 cm for men, ≥80 cm for women), elevated triglycerides (≥1.7 mmol/L), elevated fasting blood glucose (≥5.6 mmol/L), and elevated blood pressure (BP) (systolic BP ≥130 or diastolic BP ≥85 mm Hg). Virological failure (VF) was defined as HIV viral load ≥1000 copies/mL. The following statistical methods were used: Chi-square test, Wilcoxon rank-sum test, and multivariable logistic regression. Among 1108 participants, the median age (interquartile range [IQR]) was 41 years (34, 49); 666 (60.1%) were females. The prevalence of MetS was 26.3% (95% confidence interval [CI] 23.9–29.1). Age (adjusted odds ratio [OR] 1.07; 95% CI 1.04–1.11), female sex (OR 3.02; 95% CI 1.55–5.91), VF (OR 1.98; 95% CI 1.01–3.87), dolutegravir (DTG)-based regimen (OR 2.10; 95% CI 1.05–4.20), hip-circumference (OR 1.03; 95% CI 1.01–1.05), T-lymphocyte count (OR 2.23; 95% CI 1.44–3.43), high-sensitivity C-reactive protein (hsCRP) (OR 1.14; 95% CI 1.01–1.29), and fasting insulin (OR 1.02; 95% CI 1.01–1.04) were significantly associated with MetS. Metabolic syndrome was highly prevalent among HIV+ adults receiving ART in Zambia and associated with demographic, clinical, anthropometric, and inflammatory characteristics. The association between MetS and dolutegravir requires further investigation, as does elucidation of the impact of MetS on ART outcomes in sub-Saharan African PWH.

Research paper thumbnail of Correlates of Hypertension among Persons Living with HIV at Livingstone Central Hospital: A Crosssectional study

Medical Journal of Zambia

Background: Persons living with HIV (PLWH) are more likely to develop hypertension and cardiovasc... more Background: Persons living with HIV (PLWH) are more likely to develop hypertension and cardiovascular disease than the HIV-negative population. The new hypertension guidelines by the American Heart Association (AHA) and the American College of Cardiology (ACC) lowered the definition of hypertension from systolic and diastolic blood pressure (BP) of ≥ 140/90mmHg to ≥ 130/80, respectively. This study was aimed at determining the prevalence and factors associated with hypertension in PLWH in Livingstone using the new hypertension diagnostic criteria. Methods: This was a cross-sectional study. We recruited 226 antiretroviral treated PLWH attending routine visits. Socio-demographic, health and clinical data including BP readings were collected. Interviewer-structured questionnaires adapted from the World Health Organization Stepwise approach to Surveillance ( WHO STEPs) and the international physical activity questionnaire (IPAQ) were used to collect data. Statistical evaluations were em...

Research paper thumbnail of Recent advances in modulation of cardiovascular diseases by the gut microbiota

Journal of Human Hypertension

The gut microbiota has recently gained attention due to its association with cardiovascular healt... more The gut microbiota has recently gained attention due to its association with cardiovascular health, cancers, gastrointestinal disorders, and non-communicable diseases. One critical question is how the composition of the microbiota contributes to cardiovascular diseases (CVDs). Insightful reviews on the gut microbiota, its metabolites and the mechanisms that underlie its contribution to CVD are limited. Hence, the aim of this review was to describe linkages between the composition of the microbiota and CVD, CVD risk factors such as hypertension, diet, ageing, and sex differences. We have also highlighted potential therapies for improving the composition of the gut microbiota, which may result in better cardiovascular health.