Key result
Early-stage, treatment-naive HIV infection was associated with decreased wave reflections, evidenced by a 16.5 ms reduction in the timing of the reflected wave compared to matched controls.
Why the study?
Does recent HIV infection alter arterial stiffness and wave reflections in treatment-naive adults compared to matched controls?
Case-Control (n=86)
No
Does recent HIV infection alter arterial stiffness and wave reflections in treatment-naive adults compared to matched controls?
Mean Difference: -16.5
Absolute Event Rate: 152% vs 168.5%
p-value: p=0.002
In early-stage, treatment-naive HIV infection, wave reflections are decreased while aortic stiffness remains similar to controls, likely due to subclinical inflammation-induced peripheral vasodilatation.
Background Human immunodeficiency virus (HIV) infection is associated with subclinical inflammation and increased cardiovascular risk. Arterial stiffness and enhanced wave reflections are markers of cardiovascular disease and independent predictors of cardiovascular risk. The effect of HIV infection, per se, on aortic stiffness and wave reflections has not been clearly defined. Methods We studied 51 adults with a recent HIV infection, free of antiretroviral treatment and AIDS diagnosis, as well as 35 controls matched for age, sex and smoking status. Carotid-femoral pulse wave velocity (PWV) and timing of the reflected wave (Tr) were measured as indices of aortic stiffness, while aortic augmentation index (AIx) and augmented pressure (AP) were measured as indices of wave reflections. Results While PWV was similar in the two populations, Tr was significantly lower in HIV-infected subjects compared to controls (by 16.5 ms, p = 0.002). In addition, AIx and AP were decreased (by 6.4%, p = 0.048 and by 3.3 mmHg, p = 0.010, respectively) in subjects with HIV infection. Moreover, HIV-infected patients compared with controls had increased values of hs-CRP [1.37 (0.85–2.53) vs. 0.75 (0.41–1.90) mg/l, p = 0.007] and interleukin-6 [1.90 (0.91–3.9) vs. 1.28 (0.80–2.65) pg/ml, p = 0.048]. Tr was negatively correlated with hs-CRP (r = −0.283, p = 0.010) and interleukin-6 (r = −0.278, p = 0.018). Conclusions Our study provides evidence of decreased wave reflections and similar aortic stiffness, as assessed by PWV, in the early stages of HIV infection in treatment-naive patients compared to controls. Subclinical inflammation and resultant peripheral vasodilatation constitute potential mediators of the whole pathophysiological process.
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Vlachopoulos et al. (2009) conducted a case-control in HIV infection (n=86). HIV infection vs. HIV-negative matched controls was evaluated on Timing of the reflected wave (Tr) (MD -16.5 ms, p=0.002). Early-stage, treatment-naive HIV infection was associated with decreased wave reflections, evidenced by a 16.5 ms reduction in the timing of the reflected wave compared to matched controls.
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