{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T09:08:09Z","timestamp":1740128889426,"version":"3.37.3"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T00:00:00Z","timestamp":1628726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100016303","name":"Medtronic Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016303","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Rheumatic heart disease (RHD) affects 41 million people worldwide, mostly in low- and middle-income countries, where it is co-endemic with human immunodeficiency virus (HIV). HIV is also a chronic inflammatory disorder associated with cardiovascular complications, yet the epidemiology of patients affected by both diseases is poorly understood.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Utilizing the Uganda National RHD Registry, we described the echocardiographic findings, clinical characteristics, medication prescription rates, and outcomes of all 73 people carrying concurrent diagnoses of HIV and RHD between 2009 and 2018. These individuals were compared to an age- and sex-matched cohort of 365 subjects with RHD only.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The median age of the HIV-RHD group was 36 years (interquartile range [IQR] 15), and 86% were women. The HIV-RHD cohort had higher rates of prior stroke\/transient ischemic attack (12% vs 5%, P\u2005=\u2005.02) than the RHD-only group, with this association persisting following multivariable adjustment (odds ratio [OR] 3.08, P\u2005=\u2005.03). Prevalence of other comorbidities, echocardiographic findings, prophylactic penicillin prescription rates, retention in clinical care, and mortality were similar between the 2 groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Patients living with RHD and HIV in Uganda are a relatively young, predominantly female group. Although RHD-HIV comorbid individuals have higher rates of stroke, their similar all-cause mortality and RHD care quality metrics (such as retention in care) compared to those with RHD alone suggest rheumatic heart disease defines their clinical outcome more than HIV does. We believe this study to be one of the first reports of the epidemiologic profile and longitudinal outcomes of patients who carry diagnoses of both conditions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciab681","type":"journal-article","created":{"date-parts":[[2021,8,4]],"date-time":"2021-08-04T19:11:34Z","timestamp":1628104294000},"page":"1543-1548","source":"Crossref","is-referenced-by-count":2,"title":["Clinical Outcomes, Echocardiographic Findings, and Care Quality Metrics for People Living With Human Immunodeficiency Virus (HIV) and Rheumatic Heart Disease in Uganda"],"prefix":"10.1093","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3009-6678","authenticated-orcid":false,"given":"Andrew Y","family":"Chang","sequence":"first","affiliation":[{"name":"Stanford Cardiovascular Institue, Stanford University, Stanford, California, USA"},{"name":"Department of Medicine, Stanford University, Stanford, California, USA"},{"name":"Department of Epidemiology and Population Health, Stanford University, Stanford, California, USA"},{"name":"Center for Innovation in Global Health, Stanford University, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joselyn","family":"Rwebembera","sequence":"additional","affiliation":[{"name":"Uganda Heart Institute, Mulago Hospital, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eran","family":"Bendavid","sequence":"additional","affiliation":[{"name":"Department of Medicine, Stanford University, Stanford, California, USA"},{"name":"Center for Innovation in Global Health, Stanford University, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmy","family":"Okello","sequence":"additional","affiliation":[{"name":"Uganda Heart Institute, Mulago Hospital, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Barry","sequence":"additional","affiliation":[{"name":"Department of Medicine, Stanford University, Stanford, California, USA"},{"name":"Center for Innovation in Global Health, Stanford University, Stanford, California, USA"},{"name":"Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea Z","family":"Beaton","sequence":"additional","affiliation":[{"name":"The Heart Institute, Cincinnati Children\u2019s Hospital Medical Center & The University of Cincinnati School of Medicine, Cincinnati, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christiane","family":"Haeffele","sequence":"additional","affiliation":[{"name":"Stanford Cardiovascular Institue, Stanford University, Stanford, California, USA"},{"name":"Department of Medicine, Stanford University, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison R","family":"Webel","sequence":"additional","affiliation":[{"name":"Department of Child, Family and Population Health Nursing, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cissy","family":"Kityo","sequence":"additional","affiliation":[{"name":"Joint Clinical Research Centre, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris T","family":"Longenecker","sequence":"additional","affiliation":[{"name":"University Hospitals Harrington Heart & Vascular Institute, Case Western Reserve University, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,8,12]]},"reference":[{"key":"2022050517224114600_CIT0001","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1016\/j.jacc.2018.06.063","article-title":"Rheumatic heart disease worldwide: JACC scientific expert panel","volume":"72","author":"Watkins","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2022050517224114600_CIT0002","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1001\/archinternmed.2012.3310","article-title":"The causes, treatment, and outcome of acute heart failure in 1006 Africans from 9 countries","volume":"172","author":"Damasceno","year":"2012","journal-title":"Arch Intern Med"},{"key":"2022050517224114600_CIT0003","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.jchf.2013.03.006","article-title":"A simplified echocardiographic strategy for heart failure diagnosis and management within an integrated noncommunicable disease clinic at district hospital level for sub-Saharan Africa","volume":"1","author":"Kwan","year":"2013","journal-title":"JACC Heart Fail"},{"key":"2022050517224114600_CIT0004","doi-asserted-by":"crossref","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","article-title":"Global burden of cardiovascular diseases and risk factors, 1990-2019: update from the GBD 2019 study","volume":"76","author":"Roth","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"2022050517224114600_CIT0005","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1097\/INF.0000000000002161","article-title":"Decreased prevalence of rheumatic heart disease confirmed among HIV-positive youth","volume":"38","author":"Hovis","year":"2019","journal-title":"Pediatr Infect Dis J"},{"key":"2022050517224114600_CIT0006","doi-asserted-by":"crossref","first-page":"1960","DOI":"10.1097\/QAI.0000000000000827","article-title":"Brief report: prevalence of latent rheumatic heart disease among HIV-infected children in Kampala, Uganda","volume":"71","author":"Gleason","year":"2016","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2022050517224114600_CIT0007","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.ebiom.2016.02.006","article-title":"Role of natural autoantibodies in Ugandans with rheumatic heart disease and HIV","volume":"5","author":"Huck","year":"2016","journal-title":"EBioMedicine"},{"key":"2022050517224114600_CIT0008","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/S0140-6736(17)32154-2","article-title":"Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990\u20132016: a systematic analysis for the Global Burden of Disease Study 2016","volume":"390","author":"GBD 2016 Disease and Injury Incidence and Prevalence Collaborators.","year":"2017","journal-title":"Lancet"},{"key":"2022050517224114600_CIT0009","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1016\/S1474-4422(12)70205-3","article-title":"HIV infection and stroke: current perspectives and future directions","volume":"11","author":"Benjamin","year":"2012","journal-title":"Lancet Neurol"},{"key":"2022050517224114600_CIT0010","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.pcad.2020.02.004","article-title":"Prevention of cardiovascular disease among people living with HIV in sub-Saharan Africa","volume":"63","author":"Okello","year":"2020","journal-title":"Prog Cardiovasc Dis"},{"key":"2022050517224114600_CIT0011","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/j.gheart.2018.02.002","article-title":"A human-centered approach to CV care: infrastructure development in Uganda","volume":"13","author":"Longenecker","year":"2018","journal-title":"Glob Heart"},{"key":"2022050517224114600_CIT0012","doi-asserted-by":"crossref","first-page":"e004037","DOI":"10.1161\/CIRCOUTCOMES.117.004037","article-title":"Rheumatic heart disease treatment cascade in Uganda","volume":"10","author":"Longenecker","year":"2017","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"2022050517224114600_CIT0013","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2008.11.029","article-title":"Echocardiographic assessment of valve stenosis: EAE\/ASE recommendations for clinical practice","volume":"22","author":"Baumgartner","year":"2009","journal-title":"J Am Soc Echocardiogr"},{"key":"2022050517224114600_CIT0014","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1016\/S0894-7317(03)00335-3","article-title":"Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography","volume":"16","author":"Zoghbi","year":"2003","journal-title":"J Am Soc Echocardiogr"},{"year":"2019","author":"Ministry of Health, Uganda.","key":"2022050517224114600_CIT0015"},{"key":"2022050517224114600_CIT0016","doi-asserted-by":"crossref","first-page":"3127","DOI":"10.1161\/CIRCULATIONAHA.112.092312","article-title":"Echocardiography screening for rheumatic heart disease in Ugandan schoolchildren","volume":"125","author":"Beaton","year":"2012","journal-title":"Circulation"},{"key":"2022050517224114600_CIT0017","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1093\/ehjci\/jeu296","article-title":"The utility of handheld echocardiography for early rheumatic heart disease diagnosis: a field study","volume":"16","author":"Beaton","year":"2015","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2022050517224114600_CIT0018","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1136\/heartjnl-2018-313171","article-title":"Community study to uncover the full spectrum of rheumatic heart disease in Uganda","volume":"105","author":"Scheel","year":"2019","journal-title":"Heart"},{"key":"2022050517224114600_CIT0019","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1057\/jphp.2012.29","article-title":"In the shadow of HIV\/AIDS: forgotten diseases in sub-Saharan Africa: global health issues and funding agency responsibilities","volume":"33","author":"Lemoine","year":"2012","journal-title":"J Public Health Policy"},{"key":"2022050517224114600_CIT0020","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1097\/QAD.0000000000001898","article-title":"Building on the HIV chronic care platform to address noncommunicable diseases in sub-Saharan Africa: a research agenda","volume":"32","author":"Vorkoper","year":"2018","journal-title":"AIDS"},{"year":"2019","author":"National Institutes of Health, Fogarty International Center.","key":"2022050517224114600_CIT0021"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciab681\/40417097\/ciab681.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/74\/9\/1543\/43525239\/ciab681.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/74\/9\/1543\/43525239\/ciab681.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T17:28:38Z","timestamp":1651771718000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/74\/9\/1543\/6348878"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,12]]},"references-count":21,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,8,12]]},"published-print":{"date-parts":[[2022,5,3]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciab681","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"type":"print","value":"1058-4838"},{"type":"electronic","value":"1537-6591"}],"subject":[],"published-other":{"date-parts":[[2022,5,1]]},"published":{"date-parts":[[2021,8,12]]}}}