Key result
ART for one year is linked to a 0.5 m/s reduction in cfPWV in HIV.
Why the study?
Cardiovascular disease is a major cause of death in people living with HIV, who exhibit increased inflammation, vascular activation biomarkers, and arterial stiffness.
Does antiretroviral therapy reduce arterial stiffness and inflammatory cytokines in treatment-naïve HIV patients?
Cohort (n=29)
No
Does antiretroviral therapy reduce arterial stiffness and inflammatory cytokines in treatment-naïve HIV patients?
Mean Difference: -0.52 (95% CI -0.87–-0.16)
Absolute Event Rate: 6.8% vs 7.3%
p-value: p=0.006
One year of ART in treatment-naïve HIV patients improves arterial stiffness and reduces systemic and vascular inflammation, potentially lowering cardiovascular risk.
ART associated with reduced aortic stiffness in treatment-naïve HIV; hypothesis-generating, should not yet change practice.
INTRODUCTION: Cardiovascular disease is a major cause of death among people living with HIV (PLH). Non-treated PLH show increased levels of inflammation and biomarkers of vascular activation, and arterial stiffness as a prognostic cardiovascular disease risk factor. We investigated the effect of one year of ART on treatment-naïve HIV(+) individuals on arterial stiffness and inflammatory and vascular cytokines. METHODS: We cross-sectionally compared aortic stiffness via tonometry, inflammatory, and vascular serum cytokines on treatment-naïve (n = 20) and HIV (-) (n = 9) matched by age, sex, metabolic profile, and Framingham score. We subsequently followed young, treatment-naïve individuals after 1-year of ART and compared aortic stiffness, metabolic profile, and inflammatory and vascular serum biomarkers to baseline. Inflammatory biomarkers included: hs-CRP, D-Dimer, SAA, sCD163s, MCP-1, IL-8, IL-18, MRP8/14. Vascular cytokines included: myoglobin, NGAL, MPO, Cystatin C, ICAM-1, VCAM-1, and MMP9. RESULTS: Treatment-naïve individuals were 34.8 years old, mostly males (95%), and with high smoking prevalence (70%). Baseline T CD4+ was 512±324 cells/mcL. cfPWV was similar between HIV(-) and treatment-naïve (6.8 vs 7.3 m/s; p = 0.16) but significantly decreased after ART (-0.52 m/s; 95% CI -0.87 to -0.16; p0.006). Almost all the determined cytokines were significantly higher compared to controls, except for MCP-1, myoglobin, NGAL, cystatin C, and MMP-9. At follow-up, only total cholesterol and triglycerides increased and all inflammatory cytokines significantly decreased. Regarding vascular cytokines, MPO, ICAM-1, and VCAM-1 showed a reduction. D-Dimer tended to decrease (p = 0.06) and hs-CRP did not show a significant reduction (p = 0.17). CONCLUSION: One year of ART had a positive effect on reducing inflammatory and vascular cytokines and arterial stiffness.
No takes yet. Share an insight, caveat, or question.
Martínez-Ayala et al. (2023) conducted a cohort in Treatment-naïve HIV (n=29). Antiretroviral therapy (ART) vs. Baseline (pre-ART) was evaluated on Carotid-femoral pulse wave velocity (cfPWV) (MD -0.52 m/s, 95% CI -0.87 to -0.16, p=0.006). One year of antiretroviral therapy significantly reduced carotid-femoral pulse wave velocity by 0.52 m/s in treatment-naïve HIV patients.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: