Key result
Neither HIV infection nor antiretroviral therapy was associated with increased carotid intima-media thickness or reduced carotid distensibility after adjusting for age and cardiovascular risk factors.
Why the study?
As life expectancy increases in HIV-positive populations and cardiovascular disease is seen more frequently, it remained unclear to what extent HIV and antiretroviral therapy associate with cardiovascular disease risk in an urban African population.
Is HIV infection or antiretroviral therapy associated with increased carotid intima-media thickness or reduced carotid distensibility in an urban African population?
Cross-Sectional (n=548)
No
Is HIV infection or antiretroviral therapy associated with increased carotid intima-media thickness or reduced carotid distensibility in an urban African population?
In an urban South African population, neither HIV infection nor antiretroviral therapy was independently associated with subclinical atherosclerosis as measured by carotid intima-media thickness and distensibility.
No evidence for HIV-specific carotid effects after adjustment; leaves open longitudinal or other vascular outcome questions in treated patients.
BACKGROUND: Life expectancy is increasing in the HIV-positive population and age-related non-communicable diseases, such as cardiovascular disease, (CVD) are seen more frequently. This study investigated to what extent HIV and antiretroviral therapy (ART) is associated with CVD risk in an urban African population. METHODS: A cross-sectional study was performed in Johannesburg, South Africa, between July 2016 and November 2017. Both HIV-positive adults (ART-naïve, or on first- or second-line ART), as well as age and sex matched HIV-negative controls who were family or friends of the HIV-positive participants were included. Data were collected on demographics, cardiovascular risk factors, HIV-related characteristics, carotid intima-media thickness (CIMT) and carotid distensibility. The association between HIV, ART and CIMT and distensibility was analysed with linear regression models, adjusting for age, gender and CVD risk factors. RESULTS: The study included 548 participants, 337 (62%) females, age 38.3 ± 9.5 years of whom 104 (19.0%) were HIV-positive, ART-naïve; 94 (17.2%) were on first-line ART; 197 (35.9%) were on second-line ART; and 153 (27.9%) were HIV-negative. Participants on second-line ART had higher CIMT and lower distensibility compared to the other groups (p < 0.001). After adjustment for age, these outcomes were similar between groups. Further adjustment for CVD and HIV-related factors did not alter the findings. CONCLUSION: Neither HIV nor ART was associated with CIMT or carotid distensibility in this urban African population. Longitudinal studies are needed to fully understand the relationship between HIV and CVD across different populations.
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Vos et al. (2019) conducted a cross-sectional in HIV / Cardiovascular disease risk (n=548). HIV infection and antiretroviral therapy vs. HIV-negative controls was evaluated on Carotid intima-media thickness (CIMT) and carotid distensibility. Neither HIV infection nor antiretroviral therapy was associated with increased carotid intima-media thickness or reduced carotid distensibility after adjusting for age and cardiovascular risk factors.
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