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[Capillaroscopy, microangiopathy, and HIV. Descriptive study of capillaroscopy findings in HIV positive patients]
Guillermo Verdejo-Muñoz1, César Gálvez-Barrón2, Borja Gracia Tello3
1Servicio de Medicina Interna. Consorci Sanitari Alt Penedès i Garraf. Barcelona. España. . guillemovil@hotmail.com.
Insights
Capillaroscopy reveals high rates of microvascular changes in HIV patients, especially capillary tortuosity and congestion. These findings suggest capillaroscopy may aid early cardiovascular risk detection in this population.
Area of Science:
- Vascular Medicine
- Infectious Diseases
Context:
- Human Immunodeficiency Virus (HIV) infection can affect various organ systems, including the microvasculature.
- Early detection of microangiopathy is crucial for managing cardiovascular risk in HIV-positive individuals.
Purpose:
- To evaluate microangiopathy in HIV-positive patients using capillaroscopy.
- To identify specific capillaroscopic alterations and their associations with patient characteristics and disease markers.
Summary:
- A cross-sectional study included 102 HIV-positive patients, assessing microvascular changes via capillaroscopy.
- High prevalence of capillaroscopic alterations (93.1%) was observed, with congestion (78.5%) and tortuosity (77.5%) being most common.
- Capillary tortuosity correlated with age and smoking; hemorrhage correlated with age, CD4 count, antiretroviral treatment, and hypertension.
Impact:
- Capillaroscopy demonstrates a high prevalence of microvascular alterations in HIV patients.
- Findings highlight the potential of capillaroscopy as an early diagnostic tool for cardiovascular involvement in HIV.
- Congestion and tortuosity are significant findings not previously reported in this context.
Background:
In this study, we aim to evaluate microangiopathy in HIV positive patients by using capillaroscopy. To date, few studies have been published on the topic. Capillaroscopy may be a tool for early diagnosis of cardiovascular involvement in this patient population.
Methodology:
Cross-sectional study with HIV positive patients >18 years. The enrolment period was set from January to June 2018. The following data were collected: demographic (sex, age), laboratory tests (duration of infection, CD4 cell count, CD4:CD8 ratio, coinfection with other viruses), antiretroviral treatment, dyslipidemia, and comorbidities (active smoking, alcoholism, high blood pressure, dyslipidaemia, diabetes, cardiopathy). The capillaroscopy and blood tests were performed simultaneously. The following alterations were evaluated in the capillaroscopy: congestion, tortuosity, haemorrhage, dilations, capillary loss, and presence of megacapillaries.
Results:
One hundred and two patients were included; 73.5% were male, mean age was 40 years (SD: 10), and mean duration of infection 4.5 years (SD: 3.1). At diagnosis, mean CD4 cell count was 408/mm3 and CD4/CD8 ratio 0.4. A number of patients (14.7%) were coinfected with the hepatitis B virus; 31.3% were active smokers and 13.7% alcoholics. Capillaroscopy alterations were found in most study patients (93.1%): congestion (78.5%), tortuosity (77.5%), haemorrhage (13.8%), dilations (11.8%), capillary loss (5%), and megacapillaries (1%). Capillary tortuosity was associated with age and smoking; and haemorrhage with age, CD4, antiretroviral treatment, and hypertension.
Conclusion:
Prevalence of capillaroscopy alterations is high in HIV positive patients, particularly tortuosity and congestion. To the best of our knowledge, the later alteration has not been previously reported in this group of patients.
