Arterial stiffness in HIV-infected youth and associations with HIV-related variables

Abstract

Children and young adults infected with HIV are at elevated risk for cardiovascular disease (CVD). However, scarce data exist on the utility of non-invasive methods to diagnose subclinical CVD, such as pulse wave velocity (PWV), a non-invasive measure of arterial stiffness. The objectives of this study were to assess the relationship of carotid-femoral PWV with subclinical atherosclerosis measured by carotid intima-media thickness (IMT), compare measurements to healthy controls, and evaluate variables associated with PWV in HIV-infected youth. One hundred and one 8-25 year-old subjects on stable antiretroviral therapy with low-level viremia or an undetectable HIV-1 RNA were enrolled, along with 86 healthy controls similar in age, sex and race. There was no significant difference in PWV between groups (median (Q1, Q3): 5.7 (5.2, 6.3) vs 5.7 (4.9, 6.5) m/s; P = 0.81). Among the HIV-infected subjects, PWV was positively correlated with both internal carotid artery (R = 0.31, P = 0.02) and carotid bulb IMT (R = 0.29, P = 0.01). In multivariable regression, only current alcohol consumption and systolic blood pressure were independently associated with PWV in the HIV-infected group (where current alcohol consumption and higher systolic blood pressure were associated with higher PWV); whereas, age, body mass index, and current marijuana use were associated with PWV in healthy controls. In this study of PWV in HIV-infected youth, measures of arterial stiffness were not different between subjects and controls. However, in HIV-infected youth, there was a significant association between PWV and carotid IMT, as well as between PWV and current alcohol consumption. Thus, PWV may have potential as a useful, non-invasive method to assess CVD risk in HIV-infected youth, but further investigation is needed.

Complications of Treatment in Youth with HIV

“…The three recent studies investigated the impact of ART on PWV in HIV-infected children and young adults to a greater extent than the previous study [43–45]. In the first study, Eckard, et al .…”

Relationship between blood lipid and arterial stiffness in hypertension

“…Dyslipidemia has been considered a possible risk factor for arterial stiffness [9][10][11][12][13][14]. In the 1980s, several animal experiments proposed that a high fat diet might cause an abnormal rise in PWV in simians [9][10].…”

“…In the 1980s, several animal experiments proposed that a high fat diet might cause an abnormal rise in PWV in simians [9][10]. Although some evidence for positive correlation had been reported in healthy adults [11][12][13] and HIV-infected patients [14], the relationship between arterial stiffness and dyslipidemia, especially in hypertensions, had been debated for decades. In 2009, Cecelja et al [15] systematically reviewed the crosssection studies of carotid-femoral PWV (cfPWV) in multivariable regression models.…”

Early vascular aging in the HIV infected: Is arterial stiffness assessment the ideal tool?

“…13 Only in the HIV infected youths they found a positive association between IMT and arterial stiffness. This relationship does provide some new insight, but precludes one from using arterial stiffness (PWV) as an early marker of vascular function in this population, due to similar PWV in the HIV infected and uninfected groups.…”

“…11 This issue of Virulence features an article by Eckard et al evaluating arterial stiffness in HIV-infected youth. 13 The paper is timely, since the majority of studies on atherosclerotic risk among people living with HIV, focus on the elderly. Eckard et al addressed this knowledge gap by including HIV infected children and young adults on stable ART and with low levels of viremia.…”