VIH y estado de TARV al inicio asociados longitudinalmente con un aumento de la velocidad de la onda de pulso:...

People living with HIV (PLWH) have an increased risk of cardiovascular disease (CVD), but longitudinal data from middle-income settings remain limited. This study examined the association between HIV, antiretroviral therapy (ART), and pulse wave velocity (PWV), a marker of arterial stiffness and CVD risk.

A longitudinal analysis from the Ndlovu Cohort Study, South Africa.

The study included 705 participants (325 PLWH, 81% on ART at baseline, 19% initiating ART at baseline, and 380 HIV-negative people. Demographic data, HIV/ART status, and covariates were collected at baseline, while PWV was measured at 12 and 36 months. Mixed-effects models were used to analyse PWV changes over time, adjusting for age, sex, and systolic blood pressure (SBP). Results were reported as beta coefficients (β) with 95% confidence intervals (CI).

At baseline, PLWH were older and predominantly female (67%) compared to HIV-negative people. At 12 months, median PWV was higher in PLWH (7.3 m/s) than in HIV-negative people (7.0 m/s, p=0.001). Over 36 months, PWV increased by 0.30 m/s in PLWH and 0.20 m/s in HIV-negative people (p = 0.002). ART-naïve individuals had the largest PWV increase after starting ART (6.8 m/s at 12 months to 7.4 m/s at 36 months, p = 0.001). HIV (β=0.65, 95% CI: 0.24-1.06, p = 0.002) and time (β=0.31 m/s per year, p < 0.001) were significantly associated with higher PWV.

PWV increased over time, particularly in PLWH, with ART initiation linked to rapid increases. These findings highlight the need for early CVD risk monitoring, especially post-ART initiation, in resource-limited settings.