Key result
HIV ART initiation is linked to an ~4 mm Hg greater SBP rise versus uninfected controls.
Why the study?
What is the association between T-cell counts, blood pressure, and mortality in people with HIV starting ART?
Cohort (n=1,000)
Yes
What is the association between T-cell counts, blood pressure, and mortality in people with HIV starting ART?
Absolute Event Rate: 4.7% vs 0.4%
p-value: p=<0.0001
In people with HIV starting ART, an SBP <90 mm Hg is a strong predictor of early mortality, highlighting the need to screen for occult infections.
May support closer BP monitoring in PWH starting ART; leaves open causal role of HIV versus therapy.
T-cell counts on ART were associated with greater increases in blood pressure, both on average and within individuals. In addition, PWH with a systolic blood pressure (SBP) <90 mm Hg at the time of ART initiation had ~30% mortality in the following 3 months due to occult infections. These patients require careful investigation for occult infections, and those with tuberculosis may benefit from corticosteroids.
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Reis et al. (2020) conducted a cohort in HIV (n=1,000). Antiretroviral therapy (ART) vs. HIV-uninfected controls was evaluated on Change in systolic blood pressure (SBP) from baseline to 24 months (p=<0.0001). People with HIV initiating antiretroviral therapy experienced a significantly greater increase in systolic blood pressure (4.7 mm Hg) over 2 years compared to HIV-uninfected controls (0.4 mm Hg).
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