Terapia antirretroviral altamente eficaz para infecção pelo vírus da imunodeficiência humana aumenta a rigidez aórtica

Eira, Margareth; Benseñor, Isabela M.; Dórea, Egı́dio Lima; Cunha, Roberto S.; Mill, José Geraldo; Lotufo, Paulo A.

doi:10.1590/s0066-782x2012005000110

Cited by 17 publications

(12 citation statements)

References 26 publications

(36 reference statements)

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“…We found a greater cfPWV in treatment- naïve individuals living with HIV compared to controls, which agrees with previous reports in non-treated HIV infection [ 19 , 39 , 40 ]; however, others have reported similar cfPWV compared to controls [ 31 , 41 , 42 ]. As in our study, Schillaci et al [ 43 ] found, besides increased cfPWV, lower BMI, and HDL-c in individuals living with HIV without ART.…”

Section: Discussionsupporting

confidence: 92%

“…It has been reported that ART, specially protease inhibitors (PI), deteriorate arterial function [ 28 ]. Unfortunately, a significant amount of available literature looking at cfPWV in HIV combines both individuals on ART and treatment- naïve [ 29 – 31 ]. As a result, the impact of HIV infection per se on arterial function is not clear.…”

Section: Introductionmentioning

confidence: 99%

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

Martínez-Ayala

Alanis-Sánchez

Gonzalez-Hernández

et al. 2020

BMC Cardiovasc Disord

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Background 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. Methods 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. Results 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. Conclusion 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.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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

Martínez-Ayala

Alanis-Sánchez

Gonzalez-Hernández

et al. 2020

BMC Cardiovasc Disord

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“…183 Circulating microparticles released from ECs are an emerging vascular biomarker class and seem to be elevated in patients with AD with vascular risk factors compared with patients with AD without vascular risk factors, although they are not associated with cognitive decline. 202 Despite the growing panoply of useful biomarkers, they still fail to explain all of the associations between vascular risk and cognitive decline, 206 indicating that either the biomarkers are insufficient markers of the underlying processes or additional processes remain to be discovered.…”

Section: Neurovascular Biomarkers Of Cognitive Dysfunctionmentioning

confidence: 99%

The Neurovasculome: Key Roles in Brain Health and Cognitive Impairment: A Scientific Statement From the American Heart Association/American Stroke Association

Iadecola¹,

Smith²,

Anrather³

et al. 2023

Stroke

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BACKGROUND: Preservation of brain health has emerged as a leading public health priority for the aging world population. Advances in neurovascular biology have revealed an intricate relationship among brain cells, meninges, and the hematic and lymphatic vasculature (the neurovasculome) that is highly relevant to the maintenance of cognitive function. In this scientific statement, a multidisciplinary team of experts examines these advances, assesses their relevance to brain health and disease, identifies knowledge gaps, and provides future directions. METHODS: Authors with relevant expertise were selected in accordance with the American Heart Association conflict-of-interest management policy. They were assigned topics pertaining to their areas of expertise, reviewed the literature, and summarized the available data. RESULTS: The neurovasculome, composed of extracranial, intracranial, and meningeal vessels, as well as lymphatics and associated cells, subserves critical homeostatic functions vital for brain health. These include delivering O 2 and nutrients through blood flow and regulating immune trafficking, as well as clearing pathogenic proteins through perivascular spaces and dural lymphatics. Single-cell omics technologies have unveiled an unprecedented molecular heterogeneity in the cellular components of the neurovasculome and have identified novel reciprocal interactions with brain cells. The evidence suggests a previously unappreciated diversity of the pathogenic mechanisms by which disruption of the neurovasculome contributes to cognitive dysfunction in neurovascular and neurodegenerative diseases, providing new opportunities for the prevention, recognition, and treatment of these conditions. CONCLUSIONS: These advances shed new light on the symbiotic relationship between the brain and its vessels and promise to provide new diagnostic and therapeutic approaches for brain disorders associated with cognitive dysfunction.

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“…The leave-one-out sensitivity analysis disclosed some difference in results (Supplemental Digital Content, Table S9), with SMD ranging from 0.182 (p = 0.127), after removing the study of Eira [24], to 0.41 (p < 0.001) excluding the study of Kooij [16]. However, after the exclusion of these or other individual studies included in the meta-analysis, the point estimate of the combined effect size remained inside the confidence interval of the overall estimate with all available studies.…”

Section: Comparison Of Hiv Patients Treated With Antiviral Drugs Withmentioning

confidence: 99%

Aortic Stiffness in HIV Infection with and without Antiretroviral Therapy. A Meta-analysis of Observational Studies

Mulè¹,

Mulè²,

Tranchida³

et al. 2020

Artery Res

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Keywords HIV infection cardiovascular risk pulse wave velocity aortic stiffness A B S T R A C TBackground: The risk of Cardiovascular (CV) events is higher in HIV-infected patients (HIV+) compared to HIV-uninfected persons (HIV−). Large artery stiffness, a well-documented predictor of adverse CV prognosis, may mediate this enhanced risk. It is usually assessed by measuring aortic Pulse Wave Velocity (aPWV). Studies examining arterial stiffness in HIV+ yielded inconsistent results. We performed a meta-analysis with the aim to evaluate the association of HIV infection and its therapy [Antiretroviral Therapy (ART)] with aPWV. Design and Method:The Standardized Mean Difference (SMD) and corresponding 95% confidence intervals were calculated for aPWV in different comparison groups. Statistical heterogeneity, assessed by Q-test and I 2 statistic, was observed in all these comparisons. Therefore, random effects model was implemented.Results: In a total of 12 studies, naive HIV+ (n = 547) showed increased aPWV compared to HIV− (n = 864): SMD = 0.333 (0.125-0.542), p < 0.002. A total of 22 studies were identified comparing HIV+ treated with ART (n = 3348) to HIV− (n = 2547) showing higher values of aPWV in the former than in latter: SMD = 0.391 (0.225-0.556), p < 0.001. In 10 studies, HIV+ treated with ART (n = 761) exhibited greater aPWV values than those of naive HIV+ (n = 457): SMD = 0.262 (0.006-0.518), p = 0.045. Conclusion:Our meta-analysis seems to suggest that HIV infection "per se" and ART may impair aortic distensibility. However, interpretation of our results needs caution due to between-study heterogeneity and some potential publication biases.

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Terapia antirretroviral altamente eficaz para infecção pelo vírus da imunodeficiência humana aumenta a rigidez aórtica

Abstract: Background: Highly active antiretroviral therapy for AIDS is known to increase cardiovascular risk, but the effects of potent antiretroviral agents according to gender are unknown.

Cited by 17 publications

References 26 publications

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

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

The Neurovasculome: Key Roles in Brain Health and Cognitive Impairment: A Scientific Statement From the American Heart Association/American Stroke Association

Aortic Stiffness in HIV Infection with and without Antiretroviral Therapy. A Meta-analysis of Observational Studies

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