A Pilot Study of Retinal Vessel Calibre and Its Potential Link to Cardiovascular Risk in HIV

Area of Science:

• Ophthalmology
• Infectious Diseases
• Vascular Biology

Background:

• Human immunodeficiency virus (HIV) infection and its treatment with antiretroviral therapy (ART) can affect systemic health.
• Retinal vessel calibre changes may indicate compromised inner blood-retinal barrier integrity and endothelial dysfunction in people living with HIV (PLHIV).

Purpose of the Study:

• To investigate the impact of HIV and ART on retinal vessel calibre in immunocompetent PLHIV.
• To explore potential correlations between ART duration and retinal microvasculature changes.

Main Methods:

• A cross-sectional study involving fundus photography of HIV-positive individuals on ART (HIV-ART), HIV-positive ART-naïve individuals (HIV-NART), and HIV-negative controls.
• Retinal vessel calibres, including arteriolar and venular widths, central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and arteriole-venule ratio (AVR), were analyzed using VAMPIRE software.
• Statistical analyses included multivariable regression, generalized estimating equations, and mixed-effects models.

Main Results:

• People living with HIV (PLHIV) exhibited significantly wider venular widths compared to HIV-negative controls.
• Longer ART duration was associated with narrower venules (mean venular width and CRVE) but wider arterioles (CRAE) in the HIV-ART group.
• HIV-ART-naïve individuals had a higher likelihood of abnormal CRAE compared to controls.

Conclusions:

• Retinal vessel calibre alterations in PLHIV may be linked to systemic vascular health, offering insights into HIV's systemic effects.
• Clinicians should consider ART's potential influence on the retinal microvasculature.
• Further research with larger cohorts and longitudinal studies is recommended to confirm these findings and track changes over time.