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Published on: January 5, 2016
Endothelial activation and cardiometabolic profiles of treated and never-treated HIV infected Africans
C M T Fourie1, A E Schutte2, W Smith1
1Hypertension in Africa Research Team (HART), North-West University, Potchefstroom 2520, South Africa.
Insights
Human immunodeficiency virus (HIV) infection causes endothelial activation, marked by elevated adhesion molecules, even without increased inflammation or arterial stiffness. Antiretroviral treatment (ART) did not fully resolve these cardiovascular disease risk factors in African adults.
Area of Science:
- Cardiovascular Science
- Infectious Diseases
- Immunology
Background:
- Cardiovascular disease (CVD) is a significant concern in individuals with human immunodeficiency virus (HIV).
- The impact of HIV and antiretroviral treatment (ART) on endothelial activation and its link to CVD requires further investigation.
- Understanding these relationships is crucial for managing CVD risk in HIV-infected populations.
Purpose of the Study:
- To investigate endothelial activation, inflammatory markers, cardiometabolic profiles, and vascular function in HIV-infected Africans on ART, never-treated (no-ART), and HIV-negative controls.
- To determine the association between HIV status, ART, and markers of endothelial dysfunction.
- To explore the relationship between endothelial activation and cardiovascular risk factors.
Main Methods:
- Cross-sectional study comparing three groups: ART-treated HIV, never-treated HIV, and HIV-negative individuals.
- Biochemical analyses of blood samples were performed.
- Measurements included blood pressure, pulse wave velocity (PWV), and carotid intima-media thickness (IMT).
Main Results:
- HIV infection was associated with elevated intracellular adhesion molecule (ICAM) and vascular cell adhesion molecule (VCAM) levels compared to controls.
- Higher odds of increased adhesion molecules were observed in HIV-infected individuals, particularly in the no-ART group.
- Despite endothelial activation, inflammatory markers (CRP, IL-6), PWV, and IMT did not significantly differ between the groups. The ART group showed an unfavorable lipid profile compared to the no-ART group.
Conclusions:
- HIV-infected Africans exhibit endothelial activation, indicated by elevated adhesion molecules, irrespective of ART status.
- This endothelial activation was not associated with increased systemic inflammation, arterial stiffness, or sub-clinical atherosclerosis in this cohort.
- Further research is needed to elucidate the long-term cardiovascular implications of HIV-associated endothelial activation and ART's role in mitigating these effects.
Objective:
The role the human immunodeficiency virus (HIV) and antiretroviral treatment on endothelial activation, and the subsequent relationship with cardiovascular disease, is not well understood. We investigated endothelial activation, inflammatory and cardiometabolic profiles, and measures of vascular structure and function of 66 antiretroviral treated (ART), 78 never-treated (no-ART) HIV infected and 165 HIV free Africans.
Methods:
Blood samples were obtained for biochemical analysis and blood pressure, pulse wave velocity (PWV) and carotid intima-media thickness (IMT) measurements were performed.
Results:
The HIV infection duration was at least five years and the treatment 2.86±0.13 years. The intracellular adhesion molecule (ICAM) and vascular cell adhesion molecule (VCAM) levels were elevated in the HIV infected groups compared to the controls. The odds of higher adhesion molecule levels were increased when HIV infected (especially in the no-ART group); OR no-ART vs. no-HIV: ICAM 3.92 (2.2-7.0); VCAM 16.2 (7.5-35). ICAM and VCAM associated with HIV status and interleukin-6 (IL-6) in the total group (all p<0.01). In both HIV infected groups VCAM associated inversely with CD4 counts (no-ART: β=-0.28, p=0.01; ART: β=-0.22, p=0.07) and TC (no-ART: β=-0.36, p<0.01; ART: β=-0.27, p=0.03). The ART group had an unfavourable lipid profile compared to the no-ART group. The inflammatory markers (C-reactive protein (CRP) and IL-6), PWV and IMT did not differ between the three groups.
Conclusion:
HIV infected Africans showed endothelial activation when compared to HIV free controls. The endothelial activation was not accompanied by increased inflammation (as measured with CRP and IL-6), arterial stiffness or sub-clinical atherosclerosis.
