Aortic stiffness and central hemodynamics in treatment-naïve HIV infection: a cross-sectional study

• Published in: BMC cardiovascular disorders Vol. 20; no. 1; p. 440
• Main Authors: Martínez-Ayala, Pedro, Alanis-Sánchez, Guillermo Adrián, González-Hernández, Luz Alicia, Álvarez-Zavala, Monserrat, Cabrera-Silva, Rodolfo Ismael, Andrade-Villanueva, Jaime Federico, Sánchez-Reyes, Karina, Ramos-Solano, Moisés, Castañeda-Zaragoza, Diego Alberto, Cardona-Müller, David, Totsuka-Sutto, Sylvia, Cardona-Muñoz, Ernesto, Ramos-Becerra, Carlos G
• Format: Journal Article
• Language: English
• Published: England BioMed Central 07-10-2020; BMC
• Subjects: Adult; Age; Antiretroviral therapy; Aorta; Arterial stiffness; Arteriosclerosis; Blood Pressure; Body mass index; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - physiopathology; Cardiovascular risk; Carotid-Femoral Pulse Wave Velocity; Case-Control Studies; CD4 antigen; Cholesterol; Chronic infection; Chronic inflammation; Cross-Sectional Studies; Diabetes; Female; Generalized linear models; Heart Disease Risk Factors; Heart rate; Hemodynamics; HIV; HIV infection; HIV Infections - diagnosis; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Infections; Inflammation; Lipids; Lymphocytes T; Male; Manometry; Metabolism; Mexico - epidemiology; Oxidative stress; Prevalence; Pulse wave velocity; Risk Assessment; Risk factors; Serology; Smoking; Standard deviation; Vascular Stiffness; Young Adult; Mexico; United States > US; Arterial stiffness; Chronic inflammation; Arteriosclerosis; Cardiovascular risk; Central pulse pressure; Pulse wave velocity; HIV infection
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-020-01722-8

Human immunodeficiency virus (HIV) infection is associated with a greater risk of cardiovascular disease (CVD). HIV infection causes a chronic inflammatory state and increases oxidative stress which can cause endothelial dysfunction and arterial stiffness. Aortic stiffness measured by carotid femoral-pulse wave velocity (cfPWV) and central hemodynamics are independent cardiovascular risk factors and have the prognostic ability for CVD. We assessed cfPWV and central hemodynamics in young individuals with recent HIV infection diagnosis and without antiretroviral therapy. We hypothesized that individuals living with HIV would present greater cfPWV and central hemodynamics (central systolic blood pressure and pulse pressure) compared to uninfected controls.
We recruited 51 treatment-naïve individuals living with HIV (HIV(+)) without previous CVD and 51 age- and sex-matched controls (HIV negative (-)). We evaluated traditional CVD risk factors including metabolic profile, blood pressure (BP), smoking, HIV viral load, and CD4
T-cells count. Arterial stiffness and central hemodynamics were evaluated by cfPWV, central systolic BP, and central pulse pressure (cPP) via applanation tonometry.
HIV(+) individuals presented a greater prevalence of smoking, reduced high-density lipoprotein cholesterol, and body mass index. 65.9% of HIV(+) individuals exhibited lymphocyte CD4
T-cells count < 500 cells/μL. There was no difference in brachial or central BP between groups; however, HIV(+) individuals showed significantly lower cPP. We observed a greater cfPWV (mean difference = 0.5 m/s; p < 0.01) in HIV(+) compared to controls, even after adjusting for heart rate, mean arterial pressure and smoking.
In the early stages of infection, non-treated HIV individuals present a greater prevalence of traditional CVD risk factors, arterial stiffness, and normal or in some cases central hemodynamics.