Is arterial stiffness in HIV-infected individuals associated with HIV-related factors?

Monteiro, Polyana; Miranda-Filho, Demócrito Barros; Bandeira, Francisco; Lacerda, Heloísa Ramos; Chaves, Hilton; Albuquerque, M. F. P. M.; Montarroyos, UR; Ximenes, Ricardo A. A.

doi:10.1590/s0100-879x2012007500116

Cited by 27 publications

(32 citation statements)

References 41 publications

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“…Previous studies in the South indicated an association between fewer years of schooling and metabolic syndrome in men [19]. In the Northeast, an association between male sex and subclinical atherosclerosis [20] and higher velocity of pulse wave was observed, similar to the observations among HIVnegative individuals [21].…”

Section: Discussionsupporting

confidence: 80%

Comparison between potential risk factors for cardiovascular disease in people living with HIV/AIDS in areas of Brazil

Ximenes

Lacerda

Miranda-Filho

et al. 2015

J Infect Dev Ctries

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Introduction: Coronary heart disease and its risk factors depend on genetic characteristics, behaviors, and habits, all of which vary in different regions. The use of antiretroviral therapy (ARV) has increased the survival of people living with HIV/AIDS (PLWHA), who begin to present mortality indicators similar to the general population. This study aimed to compare the prevalence of factors potentially associated with coronary heart disease in three cohorts of PLWHA from three different regions of Brazil. Methodology: The study population was composed of participants of the cohorts of Pernambuco, Goiás, and Rio Grande do Sul states. In these sites, adult patients attending reference centers for treatment of HIV/AIDS were consecutively enrolled. Results: Pernambuco and Goiás had a higher proportion of males and of individuals with high-risk high-density lipoprotein (HDL). Pernambuco also had a greater proportion of individuals with hypertension, elevated triglycerides, and CD4 counts below 200 cells/mm 3 . Lower education was more frequent in Rio Grande do Sul, and the use of cocaine was higher in this state. Conclusions: The results confirm the importance of risk factors for coronary heart disease in PLHIV and highlight differences in the three cohorts. Specific measures against smoking and sedentary lifestyle, avoidance of advanced stages of immunosuppression, and appropriate treatment of dyslipidemia and dysglicemia are urgently needed to cope with the disease in Brazil.

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Section: Discussionsupporting

confidence: 80%

Comparison between potential risk factors for cardiovascular disease in people living with HIV/AIDS in areas of Brazil

Ximenes

Lacerda

Miranda-Filho

et al. 2015

J Infect Dev Ctries

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“…Amongst the HIV infected with a CD4 count < 200 cells/mm 3 the PWV was significantly higher (p < 0.05) than in patients with a count of CD4 lymphocytes ≥ 200 cells/mm 3 . As in the study by Monteiro et al [15], our mean number of CD4 lymphocytes recorded on the NADIR was below 200 cells/mm 3 ; however, we did not confirm significant differences in the number of CD4 lymphocytes in patients with and without dysfunctional endothelium. It is possible that the adopted RHI and AI@75 method of evaluating the vessel stiffness, being less sensitive than PWV, could have influenced the results of our analyses [15].…”

Section: Discussioncontrasting

confidence: 92%

“…In a Brazilian study, Monteiro et al [15] analysed the relationship between the PWV, HIV, antiretroviral therapy, HIV viraemia, CD4 NADIR, metabolic disorders and CVD. They compared the results of 261 HIV infected patients with a group of 82 healthy subjects.…”

Section: Discussionmentioning

confidence: 99%

The effects of CD4 nadirs on vessel stiffness in HIV patients undergoing antiretroviral therapy

et al. 2017

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A b s t r a c tBackground: There are many factors associated with human immunodeficiency virus (HIV) patients having a greater risk of cardiovascular diseases (CVD). HIV damages vessel endothelium through chronic inflammation, which, combined with dyslipidaemia, arterial hypertension, and antiretroviral therapy leads to the progression of atherosclerotic changes. Aim:Our goal was to determine if a CD4 nadir along with immunological, inflammatory, biochemical, and metabolic markers can be associated with higher vessel stiffness and therefore an increased risk of CVD in patients undergoing antiretroviral therapy for HIV. Methods:Endothelial damage was evaluated in 20 patients (including four female) during successful antiretroviral therapy. We assessed the endothelial stiffness by recording the reactive hyperaemia of peripheral arteries using an Endo-PAT2000 (ITAMAR ® ) device. This device allowed us to measure the arterial tonometry and to determine the augmentation index for a pulse rate of 75/min (AI@75). We set the normal value for vessel stiffness at reactive hyperaemia index (RHI) > 1.67, as recommended by the manufacturer. Additionally, we recorded the length of antiretroviral therapy, number of CD4 lymphocytes, CD4 nadir, HIV viremia, and biochemical and immunologic results. Finally, we compared patients with normal and dysfunctional endothelium. Results:The only parameter significantly differentiating between the group with and group without endothelium dysfunction was platelet count (p = 0.012). Conclusions:We were not able to confirm the significance of a CD4 nadir in the progression of endothelial stiffness in HIV patients. However, platelet values could be an important complementary marker for assessing the risk for CVD amongst HIV patients undergoing antiretroviral treatment.

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“…For hemodynamic parameters, age and MAP were forced into the models. For AIx and PPA, heart rate and gender were also forced into the multivariate models [33][34].…”

Section: Discussionmentioning

confidence: 99%

“…Arterial parameters of the study population are summarized in (28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) mmHg, respectively. Median value (IQR) for carotid-femoral PWV in our study population was 8.3(7.5-9.5) m/sec, which was slightly higher than the theoretical carotid-femoral PWV calculated by age category on the basis of MAP [median (IQR): 8.0(7.4-9.1) m/sec].…”

Section: Central and Peripheral Arterial Parametersmentioning

confidence: 99%

Structural and Functional Arterial Parameters, Immunovirological Control and Vitamin D in HIV-Infected Patients

Yannoutsos¹

2014

J AIDS Clin Res

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Objective: HIV-infected patients still experience higher Cardiovascular (CV) mortality rates, even if an adequate viral suppression is achieved. In addition, vitamin D insufficiency, a common condition in HIV-infected patients, is increasingly associated with CV risk. We therefore aim to investigate relationships between immunological parameters, antiretroviral therapy, plasma vitamin D and arterial parameters, including aortic stiffness and wave reflections, in HIV-infected patients who achieved viral suppression but possibly remain at increased CV risk. Methods:We conducted a cross-sectional study including 178 middle-aged HIV-infected patients. HIV infection was controlled in a large number of participants, representative of a real-world setting. In addition to carotid Intima Media Thickness (IMT), central hemodynamic parameters involved aortic Pulse Wave Velocity (PWV), carotid Augmentation index (AIx) and Pulse Pressure Amplification (PPA) measured noninvasively using applanation tonometry.Results: Aortic PWV was slightly but unsignificantly higher than the theoretical values obtained in general population according to age and blood pressure, and was independent of HIV-related parameters. In univariate and multivariate analyses, carotid AIx was positively correlated with current CD4 T-cell count and PPA was positively correlated with vitamin D, independently of other confounders. No HIV-related parameters or vitamin D entered the multivariate analysis of carotid IMT / plaque. Conclusion:In our chronically treated population, HIV infection was not associated with increased aortic stiffness but with a positive correlation between current CD4 T-cell count and degree of AIx, suggesting that patients with higher CD4 T-cell count may have higher wave reflections. The positive correlation between vitamin D and PPA suggests that vitamin D deficiency may be independently associated with altered central hemodynamics in well controlled HIV-infected patients. These findings should be confirmed in prospective studies.

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Is arterial stiffness in HIV-infected individuals associated with HIV-related factors?

Cited by 27 publications

References 41 publications

Comparison between potential risk factors for cardiovascular disease in people living with HIV/AIDS in areas of Brazil

Comparison between potential risk factors for cardiovascular disease in people living with HIV/AIDS in areas of Brazil

The effects of CD4 nadirs on vessel stiffness in HIV patients undergoing antiretroviral therapy

Structural and Functional Arterial Parameters, Immunovirological Control and Vitamin D in HIV-Infected Patients

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