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Particular Aspects Related to CD4+ Level in a Group of HIV-Infected Patients and Associated Acute Coronary Syndrome

Mircea Bajdechi1,2, Adriana Gurghean1, Vlad Bataila3

  • 1Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila" of Bucharest, 050474 Bucharest, Romania.

Diagnostics (Basel, Switzerland)
|August 26, 2023
PubMed

Insights

People with HIV infection face high cardiovascular risks. Lower CD4+ T-cell counts correlated with complex coronary lesions and increased risks, but not significantly different major adverse cardiac events at one year.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Immunology

Background:

  • Individuals with HIV are prone to cardiovascular events due to chronic inflammation and atherosclerosis.
  • Certain antiretroviral therapies can also elevate cardiovascular risk.
  • Immune status, particularly CD4+ T-cell counts, is implicated in cardiovascular complications in HIV patients.

Purpose of the Study:

  • To analyze the relationship between immune status (nadir CD4+ T-cell count) and cardiovascular outcomes in HIV patients with acute coronary syndrome.
  • To assess the magnitude of coronary lesions, and thrombotic and bleeding risks in relation to immune status.

Main Methods:

  • A longitudinal, retrospective study involving 50 HIV patients with acute coronary syndrome.
  • Patients were divided into subgroups based on their nadir CD4+ T-cell count.
  • Clinical, biological, and coronary lesion parameters were assessed, along with specific risk scores.

Main Results:

  • Patients with poorer immune status (lower nadir CD4+ counts) exhibited more complex coronary lesions.
  • Increased operative and bleeding risks were observed in patients with lower CD4+ counts at one year.
  • No significant differences in major adverse cardiac and cerebrovascular events were found at 30 days and one year between subgroups.

Conclusions:

  • While lower CD4+ T-cell counts in HIV patients are associated with more complex coronary artery disease and higher operative/bleeding risks, these factors did not translate to significantly worse major adverse cardiac and cerebrovascular event rates at one year.
  • Immune status, as indicated by CD4+ nadir, is a relevant factor in assessing cardiovascular risk stratification in HIV-infected individuals.

Keywords:
CD4+ lymphocytesHIVacute coronary syndromeatherosclerosischronic inflammation

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