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Despite the majority of PLWH residing in sub-Saharan Africa, there are limited reports from the region on structural cardiovascular changes due to this residual risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>The Early Structural Cardiovascular Disease, HIV, and Tuberculosis in East Africa (ASANTE) cross-sectional study will be conducted in a public hospital in Nairobi, Kenya. It will enrol 400 participants (50% women, 50% PLWH) to undergo cardiovascular phenotyping using multimodal imaging (coronary CT angiography (CCTA) and echocardiography) and banking of biological samples (whole blood, peripheral blood mononuclear cells, plasma and urine). We will define the prevalence of subclinical coronary atherosclerosis by CCTA and subclinical myocardial dysfunction by transthoracic echocardiography and evaluate both traditional and non-traditional risk factors, including endemic infections such as latent tuberculosis. This study will contribute important data on phenotypes of and risk factors for HIV-associated cardiovascular disease in this understudied region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval for the ASANTE study was granted by the University of Nairobi-Kenyatta National Hospital Ethical Review Committee, Nairobi, Kenya, and the University of Washington Institutional Review Board, USA. Results will be submitted for publication in peer-reviewed journals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-102684","type":"journal-article","created":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T13:50:35Z","timestamp":1752241835000},"page":"e102684","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Early structural cardiovascular disease, HIV, and tuberculosis in East Africa (ASANTE): cross-sectional study protocol for a multimodal cardiac imaging study in Nairobi, Kenya"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7775-006X","authenticated-orcid":false,"given":"Saate S","family":"Shakil","sequence":"first","affiliation":[{"name":"Department of Medicine, University of California, Los Angeles, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sidney","family":"Korir","sequence":"additional","affiliation":[{"name":"Kenyatta National Hospital, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geoffrey","family":"Omondi","sequence":"additional","affiliation":[{"name":"Kenyatta National Hospital, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boni Maxime","family":"Ale","sequence":"additional","affiliation":[{"name":"UNITID, University of Nairobi, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard","family":"Gitura","sequence":"additional","affiliation":[{"name":"Cardiology, Kenyatta National Hospital, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marian","family":"Morris","sequence":"additional","affiliation":[{"name":"Radiology, Coptic Hospital, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Kinuthia","sequence":"additional","affiliation":[{"name":"Kenyatta National Hospital, Nairobi, Kenya"},{"name":"Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhavna","family":"Chohan","sequence":"additional","affiliation":[{"name":"Global Health, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norrisa","family":"Haynes","sequence":"additional","affiliation":[{"name":"Medicine\/Cardiology, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carey","family":"Farquhar","sequence":"additional","affiliation":[{"name":"Global Health, Medicine and Epidemiology, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priscilla Y","family":"Hsue","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California, Los Angeles, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris T","family":"Longenecker","sequence":"additional","affiliation":[{"name":"Global Health, Medicine\/Cardiology, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfred","family":"Osoti","sequence":"additional","affiliation":[{"name":"Kenyatta National Hospital, Nairobi, Kenya"},{"name":"Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,7,11]]},"reference":[{"key":"2025120600425494000_15.7.e102684.1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.033369"},{"key":"2025120600425494000_15.7.e102684.2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.15078"},{"key":"2025120600425494000_15.7.e102684.3","unstructured":"UNAIDS . 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