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Arterial structure and function in Africans with HIV for > 5 years: longitudinal relationship with endothelial
E Phalane1, Cmt Fourie1,2, A E Schutte1,2,3
1Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
Insights
People with HIV (PWHIV) showed similar arterial stiffness and thickness as those without HIV after five years. Traditional cardiovascular risk factors, not endothelial activation, were linked to arterial changes in PWHIV.
Area of Science:
- Cardiology
- Infectious Diseases
- Vascular Biology
Background:
- Human immunodeficiency virus (HIV) infection is associated with accelerated cardiovascular disease.
- Endothelial activation and traditional cardiovascular risk factors may contribute to arterial damage in people with HIV (PWHIV).
Purpose of the Study:
- To compare arterial structure (carotid intima-media thickness, cIMT) and function (carotid-femoral pulse wave velocity, cfPWV) between PWHIV and controls.
- To investigate the association of baseline endothelial activation and cardiovascular risk markers with cIMT and cfPWV after 5 years.
Main Methods:
- A case-control study matched 126 PWHIV with 126 controls from South Africa based on age, sex, and locality.
- Baseline measurements included cardiovascular risk factors and endothelial markers (ICAM-1, VCAM-1).
- cIMT and cfPWV were assessed at 5-year follow-up.
Main Results:
- At follow-up, cIMT and cfPWV were similar between PWHIV and controls (P > 0.05).
- Elevated baseline ICAM-1 and VCAM-1 in PWHIV did not predict cIMT or cfPWV at 5 years.
- In PWHIV, cIMT correlated with age and triglyceride:HDL-cholesterol ratio; cfPWV correlated with mean arterial pressure (MAP).
- In controls, cIMT correlated with sex and HbA1c; cfPWV correlated with age, sex, MAP, and HbA1c.
Conclusions:
- Arterial structure and function were comparable between PWHIV and matched controls in this South African cohort.
- Traditional cardiovascular risk factors, rather than baseline endothelial activation markers, were independently associated with arterial measures over 5 years.
Objectives:
We aimed to determine whether people with human immunodeficiency virus (PWHIV) have increased measures of arterial injury [carotid intima-media thickness (cIMT)] and large artery stiffness [carotid-femoral pulse wave velocity (cfPWV)] when compared with their counterparts without HIV, and whether baseline markers of endothelial activation and cardiovascular risk are associated with cIMT and cfPWV after 5 years.
Methods:
We matched 126 PWHIV from North West Province, South Africa, to 126 without HIV according to age, sex and locality. Cardiovascular risk and endothelial function markers [soluble intracellular adhesion molecule (ICAM-1) and soluble vascular cell adhesion molecule (VCAM-1)] were measured at baseline and cIMT and cfPWV at follow-up.
Results:
This study included 21.4% men. The use of antiretroviral therapy (ART) increased from 44.1% at baseline to 81.4% at follow-up. At follow-up, cIMT (P = 0.90) and cfPWV (P = 0.35) were similar in the groups. Despite elevated ICAM-1 and VCAM-1 in the PWHIV (all P < 0.001) at baseline, these markers did not associate with cIMT and cfPWV after 5 years. In multivariable-adjusted regression analysis, cIMT associated positively with age (β = 0.31, P = 0.002) and triglyceride: high-density lipoprotein-cholesterol (β = 0.23, P = 0.016) in PWHIV. Mean arterial pressure (MAP) (β = 0.28, P = 0.010) associated positively with cfPWV in the PWHIV. In the people without HIV, sex (β = 0.31, P = 0.004) and glycated haemoglobin (HbA1c) (β = 0.24, P = 0.026) associated with cIMT while age (β = 0.17, P = 0.049), sex (β = 0.29, P = 0.003), MAP (β = 0.31, P = 0.001) and HbA1c (β = 0.21, P = 0.041) associated positively with cfPWV.
Conclusions:
Measures of arterial structure and function were similar in Africans with HIV and their age, sex and locality matched controls. Traditional cardiovascular risk markers rather than elevated endothelial activation at baseline were independently associated with cIMT and cfPWV over 5 years.
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