HIV and race are independently associated with endothelial dysfunction

Area of Science:

• Cardiovascular Health
• Infectious Diseases
• Vascular Biology

Background:

• Endothelial dysfunction is a critical early marker of cardiovascular disease.
• Understanding factors contributing to endothelial dysfunction in persons with HIV (PWH) is crucial for preventative strategies.

Purpose of the Study:

• To evaluate and compare vascular endothelial function between HIV-infected and HIV-uninfected individuals.
• To assess the association of body composition, inflammation, and gut integrity markers with endothelial function in PWH.

Main Methods:

• Utilized peripheral arterial tonometry (EndoPAT2000) to measure reactive hyperemia index (RHI) and Augmentation Index in 511 participants (296 PWH, 215 controls).
• Assessed markers of systemic inflammation, immune activation, and gut integrity.
• Employed linear mixed models to analyze endothelial dysfunction, with P < 0.05 considered significant.

Main Results:

• Persons with HIV (PWH) exhibited 13% lower RHI compared to HIV-uninfected individuals (P=0.01).
• Nonwhite race was associated with a 9% lower RHI (P=0.001), and protease inhibitor use showed an 8% lower RHI (P=0.04).
• Increased BMI correlated with improved RHI (0.17% increase per 1% BMI increase, P=0.01).

Conclusions:

• HIV infection, nonwhite race, and protease inhibitor use are independent risk factors for endothelial dysfunction.
• Inflammation, gut integrity markers, CD4+ cell counts, and HIV duration were not significantly associated with endothelial dysfunction in this cohort.