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March 19, 2021Southern African Journal of HIV MedicineOpen Access

HIV in lean adults on long-term ART is linked to higher cfAiX and immune activation.

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Why the study?

Data regarding immune activation and arterial stiffness among persons living with HIV in sub-Saharan Africa were lacking, particularly in lean individuals.

Does HIV infection and immune activation increase arterial stiffness in lean adults on long-term antiretroviral therapy?

Comparison

HIV-positive adults on ART >5 years vs HIV-negative controls

Design

Cross-sectional study

Key result

Lean adults with HIV on long-term antiretroviral therapy had a higher median carotid-femoral augmentation index (21.1% vs. 6.0%) and increased immune activation compared to HIV-negative persons.

Authors

LKLonga KalubaFGFastone GomaCGChris Guure

Discussion

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Overview

Arterial stiffness was associated with HIV and immune activation in lean patients on ART; hypothesis-generating and leaves open clinical event risk.

Study Design

Type

Cross-Sectional (n=74)

Multicenter

No

Structured PICO

Does HIV infection and immune activation increase arterial stiffness in lean adults on long-term antiretroviral therapy?

P
Population
74 lean adults (BMI < 25 kg/m2) with no history of cardiovascular disease, rheumatologic disease, diabetes, or tobacco smoking, comprising 48 HIV-positive adults on antiretroviral therapy for >5 years and 26 HIV-negative controls.
I
Intervention
HIV infection on long-term antiretroviral therapy (efavirenz, emtricitabine, and tenofovir disoproxil fumarate for >5 years)
C
Comparator
HIV-negative healthy controls
O
Outcome
Association between immune activation (circulating CD4+ and CD8+ T-cell subsets) and arterial stiffness (carotid-femoral pulse wave velocity [cfPWV], carotid-radial pulse wave velocity [crPWV], and augmentation indices)surrogate

Main Result

Absolute Event Rate: 21.1% vs 6%

p-value: p=0.04

Lean adults with HIV on long-term antiretroviral therapy exhibit increased immune activation and arterial stiffness compared to HIV-negative controls, highlighting cardiovascular risk even in non-obese patients.

Limitations

  • Significantly greater age and small sample size amongst the PLWH compared to HIV-negatives
  • Information on the duration of HIV infection before treatment and total CD4 and CD8 T-cell counts were not available
  • Cross-sectional design precludes determining causality
  • Significantly greater age amongst PLWH compared to HIV-negatives
  • Small sample size
  • Lack of information on duration of HIV infection before treatment
  • Lack of total CD4 and CD8 T-cell counts

Cite This Study

Kaluba et al. (2021) conducted a cross-sectional in HIV (n=74). HIV infection (on long-term ART) vs. HIV-negative was evaluated on Carotid-femoral augmentation index (cfAiX) (p=0.04). Lean adults with HIV on long-term antiretroviral therapy had a higher median carotid-femoral augmentation index (21.1% vs. 6.0%) and increased immune activation compared to HIV-negative persons.

synapsesocial.com/papers/6a0ac67e6f9280a32b5cf6b9https://doi.org/10.4102/sajhivmed.v22i1.1190
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