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Background: People living with HIV have an increased risk of cardiovascular disease (CVD). Although coronary endothelial function (CEF) is an early direct indicator of CVD, only a few studies have been able to interrogate CEF directly. Most studies have examined vascular endothelial function through indirect assessment of brachial flow‐mediated dilatation (FMD). However, peripheral arteries are significantly larger and manifest atherogenesis differently from the coronary arteries, and so produce conflicting results. Additionally, none of these studies focused on young adults who acquired HIV perinatally or in early childhood. Objective: The present study investigates CEF in a unique population of young adults with lifelong HIV using direct magnetic resonance imaging (MRI) of coronary FMD (corFMD) with an in‐house developed MRI‐integrated isometric handgrip exercise system with continuous feedback and monitoring mechanisms (fmIHE). Methods: Young adults who acquired HIV perinatally or in early childhood (n = 23) and group‐matched healthy participants (n = 12) completed corFMD‐MRI with fmIHE. CorFMD was measured as the coronary cross‐sectional area response to the fmIHE. Results: In univariable and multivariable regression analysis, HIV status was a significant risk modifier. CD8+ T‐cell count and smoking pack‐years and their interaction with HIV status were independently associated with impaired coronary artery response to fmIHE. In people living with HIV, corFMD was significantly inversely correlated with CD8+ T‐cells and smoking pack‐years. In a multivariable regression analysis adjusted for age and body mass index, CD8+ T‐cells and smoking and their interaction with HIV status remained significant independent predictors of coronary endothelial dysfunction. Discussion: In this unique population of young adults, HIV status was a significant risk modifier, and immune activation and smoking were associated with decreased CEF, directly measured from the coronary vascular response to fmIHE. Conclusions: Management of CVD risk factors such as smoking and developing strategies that target immune activation in people living with HIV are warranted. [ABSTRACT FROM AUTHOR]

Reproductive and sexual health outcomes of adults with perinatal human immunodeficiency virus (PHIV) have not been well-characterized. This prospective cross-sectional study of 35 adult persons living with HIV (PLWH) from early life and 20 matched HIV-negative controls assessed quality of life, depressive symptoms, HIV transmission knowledge, and sexual/reproductive behaviors through self-report questionnaires. PLWH scored significantly worse than controls on depressive symptoms (p = 0.04) and two of six quality of life domains (p = 0.03, p = 0.0002). In contrast, PLWH scored significantly higher on transmission knowledge in the context of family planning (p = 0.002). PLWH were more likely to learn about sex from healthcare providers (p = 0.002) and were more confident in their sexual/reproductive health knowledge (p < 0.05). Both groups reported inconsistent condom use, but PLWH were more likely to have planned pregnancies (p = 0.005) and to share pregnancy planning with their partners (p < 0.05). Despite the challenges of living with a chronic stigmatized condition, adults with PHIV were knowledgeable about HIV transmission and family planning and demonstrated sexual practices and reproductive outcomes similar to age-matched controls. However, sub-optimal rates of viral suppression, inconsistent condom use, and the psychosocial impact of living with HIV continue to require the attention of healthcare provides for young adults with PHIV. [ABSTRACT FROM AUTHOR]

The article offers information on the diagnosis and treatment for hypothyroidism, an underproduction of thyroid hormones. Risk factors for hypothyroidism include family history, postpartum thyroidectomy, and postpartum thyroiditis. Diagnoses which prompt testing for hypothyroidism include alopecia, constipation, and dementia. Also discussed are factors that may affect thyroid function test results, the standard evidence-based treatment for hypothyroidism, and complication of treatment.