Mosepele Mosepele

Oral presentations in this session covered cardiac complications, malignancies and frailty among people living with HIV (PLWHIV).

A non-inferiority trial on treatment of T1 Kaposi’s Sarcoma in RLS (A5263/AMC-066) revealed that Paclitaxel was superior, conferring 48-week progression free survival of 64% versus 48% for BleomycinVincristine and 19% for oral Etoposide. Low rates of KS-IRIS were observed suggesting chemotherapy with ART may be protective. Another important study revealed that HIV was independently associated with a 54-75% increased risk of heart failure in a USA clinical cohort. In other presentations, PLWHIV in Uganda were reported to be 13-times less likely to have coronary calcium when compared to matched PLWHIV in the USA. Having HIV was associated with minor differences in cardiac chamber size or wall thickness and no major structural changes using multidetector computer tomography (MDTC) in Copenhagen. 2.5% of young adults with perinatally acquired HIV in the UK developed malignancy by age 24 years. PLWHIV were more likely to have frailty at baseline, and progression during another study.

This session provided new guidance on treatment of Kaposi’s sarcoma in RLS. While additional information on the type of heart failure observed among PLWHIV in the USA is needed, the impact of HIV on the CV system remains a major concern. However, epidemiology of HIV associated CVD may vary by region – as the Uganda versus USA comparative analysis showed very little evidence of preclinical coronary artery disease in the African setting – despite prevalent traditional CVD risk factors in the Uganda cohort.