Letter to the Editor: Arteriopathy in Children with AIDS: Microscopic Changes in the Vasa Vasorum with Gross Irregularities of the Aortic Intima

Kabus, David; Ma, Greco

doi:10.3109/15513819109065475

Cited by 18 publications

(9 citation statements)

References 2 publications

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“…Cerebral aneurysms (Carvalho Neto et al, 2001;Dubrovsky et al, 1998;Kure et al, 1989;Leeuwis et al, 2007;Shah et al, 1996), stroke (Narayan et al, 2002;Park et al, 1990), and general arteriopathy (Joshi et al, 1990(Joshi et al, , 1987Kabus and Greco, 1991) have also been reported in HIV-infected children and adolescent populations. Due to chronic HIV infection and long-term highly-active antiretroviral therapy (HAART) treatment, particularly in pediatric and young adults, people living with HIV are at a higher risk of early onset cardiovascular disease and other non-AIDS related co-morbidities.…”

mentioning

confidence: 94%

Efavirenz and ritonavir-boosted lopinavir use exhibited elevated markers of atherosclerosis across age groups in people living with HIV in Ethiopia

Gleason

Caulk

Seifu

et al. 2016

Journal of Biomechanics

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mentioning

confidence: 94%

Efavirenz and ritonavir-boosted lopinavir use exhibited elevated markers of atherosclerosis across age groups in people living with HIV in Ethiopia

Gleason

Caulk

Seifu

et al. 2016

Journal of Biomechanics

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“…Dolichoectasia is an arterial disease characterized by elongation and tortuosity that, in the setting of HIV infection, is known as HIV-associated vasculopathy, a form of secondary dolichoectasia [4]. This vasculopathy is associated with up to a fourth of brain infarcts, as noted in a large autopsy series of patients who died with HIV infection [5]. It is typically seen among patients with severe immunosuppression and large-artery strokes, but radiographically there are no reliable methods to distinguish it from dolichoectasia in uninfected individuals, other than the clinical context [6].…”

mentioning

confidence: 99%

Metalloproteinases and Brain Arterial Remodeling Among Individuals With and Those Without HIV Infection

Gutierrez¹,

Menshawy

Goldman

et al. 2016

J Infect Dis.

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Background. This study tests the hypothesis that increased elastolytic activity is associated differentially with dolichoectasia in individuals with and those without human immunodeficiency virus (HIV) infection.Methods. Large arteries from 84 autopsied brains from HIV-positive individuals and 78 autopsied brains from HIV-negative individuals were stained for metalloproteinase 2 (MMP-2), MMP-3, MMP-9, tissue inhibitor of metalloproteinases 1 (TIMP-1), TIMP-2, CD68, and caspase 3. Average pixel intensity was automatically obtained and categorized as high, moderate, or low. Dolichoectasia was defined as a lumen to wall ratio ≥95th percentile.Results. High MMP-9 staining alone (P = .001) or coexistent with low TIMP-2 staining was associated with dolichoectasia only in HIV-negative individuals (P = <.001). In HIV-positive individuals, MMP-9 was associated with dolichoectasia only when coexpressed with caspase 3 (P = .01). Thinning of the media was associated with CD68 staining (P = <.001) in HIV-negative individuals, while caspase 3 was associated with a thinner media only in HIV-positive individuals (P = .01). Media thickness modified the association between lumen to wall ratio and MMP expression.Conclusions. A role for MMP/TIMP balance in dolichoectasia appears more prominent in HIV-negative individuals, while apoptosis, mediated by caspase 3, is the most important determinant of media thinning in HIV-infected individuals. Furthermore, apoptosis and media thickness appear to mediate the effects of MMP in the HIV-infected population.

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“…Whereas aneurysms of the great vessels can occur in the adult HIV population, CNS vasculopathy is more common in the paediatric population [65,66]. In paediat ric HIV patients, aneurysms are characteristically diffuse, fusiform dilatations of the larger arteries around the Circle of Willis [7,61].…”

Section: Hiv and Stroke In Childrenmentioning

confidence: 99%

Human immunodeficiency virus and cerebrovascular diseases – review

Richard¹,

Tampouri²,

Sackey³

et al. 2017

HIV & AIDS Review

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Human immunodeficiency virus (HIV) is thought to increase the risk of cerebrovascular disease, although few data exist linking these two disease entities. The aetiology of vasculopathy in both adults and children with HIV remains unknown. However, it has been postulated that direct infection by HIV, immune complex deposition, and impaired regulation of the immune response are the likely causes. HIVassociated vasculopathy in the cerebral circulation encompasses several forms of arterial disease occurring in the absence of any cause other than HIV infection. It includes disease of extra cranial large arteries, intracranial medium sized arteries with or without aneurysm formation and small vessel disease. The pathology appears to differ across vessel types, and the exact mechanism by which HIV induces vessel wall damage in each case remains uncertain. Furthermore, immuno suppression secondary to HIV can predispose to opportunistic infections of the central nervous sys tem. These acquired immune deficiency syndrome (AIDS)defining infections include toxoplasmosis, cryptococcal meningitis, tuberculosis, cytomegalovirus, and progressive multifocal leukoencephalop athy secondary to JC virus reactivation, which can also present as cerebrovascularlike manifestation in patients with HIV. Although several causative mechanisms have been proposed for the relationship between HIV infection and cerebrovascular diseases, including HIVassociated dyslipidaemia, endo thelial dysfunction, inflammation, and hypercoagulability, the pathogenesis of HIVvasculopathy is not completely understood. Beside the above pathological entities, HIV itself has been implicated in the pathogenesis of cerebrovascular diseases, either through direct invasion and vessel wall destruc tion or cytokinemediated vascular remodelling.

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Letter to the Editor: Arteriopathy in Children with AIDS: Microscopic Changes in the Vasa Vasorum with Gross Irregularities of the Aortic Intima

Cited by 18 publications

References 2 publications

Efavirenz and ritonavir-boosted lopinavir use exhibited elevated markers of atherosclerosis across age groups in people living with HIV in Ethiopia

Efavirenz and ritonavir-boosted lopinavir use exhibited elevated markers of atherosclerosis across age groups in people living with HIV in Ethiopia

Metalloproteinases and Brain Arterial Remodeling Among Individuals With and Those Without HIV Infection

Human immunodeficiency virus and cerebrovascular diseases – review

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