Mentored Scientist Award

Early Structural Cardiovascular Disease and HIV in East Africa

Headshot of Saate Shakil, MD, MS
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Award amount - Direct


Persons living with HIV (PLWH) face an increased risk of atherosclerotic cardiovascular disease (ASCVD) compared with the general population. However, much of this data is derived from high-income populations. Emerging data from parts of sub-Saharan Africa indicate challenge this risk outcome paradigm. Although HIV is known to be associated with myocardial inflammation and fibrosis in both high- and low-income settings including sub-Saharan Africa, HIV’s effect on vascular disease appears to differ between these geographies. Specifically, although HIV is strongly associated with accelerated atherosclerosis in studies from the high-income world, it does not appear to be a risk factor for CAD in parts of sub-Saharan Africa. Our study will investigate the prevalence of coronary and myocardial disease in a mixed cohort of HIV-infected and uninfected Kenyan adults to determine whether the cardiovascular phenotypic profile in this population matches that of a similar cohort in Uganda with low CAD prevalence. If we find that the East African population may be protected against CAD, this suggests that potential environmental or life-course exposures in the region may interrupt the atherosclerotic cascade among PLWH. These underlying mechanisms may hold promise as novel therapeutic targets to prevent and treat ASCVD among PLWH. Dr. Shakil seeks to be a leading investigator in defining these pathways. Through this award, she proposes to develop expertise in HIVassociated cardiovascular imaging research, biomarkers of HIV-associated cardiovascular disease, and immunologic study methods. She will be supported by her mentor, Dr. Priscilla Hsue, who will foster her development into a cardiovascular physician-scientist leveraging novel concepts and findings from the developing world to improve the health of populations with HIV globally.