Key result
Lower nadir CD4-T cell count was significantly correlated with worse endothelial function as measured by vascular reactivity index (p=0.003) in a healthy HIV cohort.
Why the study?
Traditional cardiovascular risk factors in HIV-infected individuals make it difficult to assess direct effects of HIV and immune factors on endothelial dysfunction and atherosclerosis risk.
Does nadir CD4-T cell count correlate with endothelial dysfunction in HIV-infected patients without major cardiovascular risk factors?
Cohort (n=19)
No
Does nadir CD4-T cell count correlate with endothelial dysfunction in HIV-infected patients without major cardiovascular risk factors?
Effect estimate: R=0.64
p-value: p=0.003
Lower nadir CD4-T cell count is independently associated with worse endothelial function in HIV-infected patients with suppressed viral load and no traditional cardiovascular risk factors, suggesting early immunologic damage has lasting vascular effects.
Lower nadir CD4 count was associated with endothelial dysfunction in treated HIV without traditional risks; leaves open whether early ART mitigates vascular injury.
OBJECTIVES: HIV-infected population may have increased risk of cardiovascular disease. The prevalence of traditional cardiovascular disease risk factors such as hypertension, diabetes and dyslipidemia in HIV-infected individuals has made it difficult to assess the direct effects of HIV and immune factors on endothelial dysfunction and associated increased risk of atherosclerosis. The purpose of this study was to investigate indicators of endothelial dysfunction in an HIV cohort without hypertension and diabetes. METHODS: We studied 19 HIV-infected patients between the ages of 25-76 years old with effectively suppressed viral load and without diagnosis of hypertension or diabetes. Endothelial function was measured by digital thermal monitoring of vascular reactivity using the VENDYS technique. Endothelial function was reported as vascular reactivity index. Systolic blood pressure and diastolic blood pressure at the time of VENDYS test were measured and latest lipid panels were recorded. The association between vascular reactivity index and CD4-T cells count, different antiretroviral therapy types (non-nucleoside reverse transcriptase, nucleoside reverse transcriptase, protease inhibitors, integrase inhibitors), vitamins use, systolic blood pressure, diastolic blood pressure, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol was investigated. RESULTS: Mean vascular reactivity index was 1.87 ± 0.53. Vascular reactivity index, marker of endothelial dysfunction, showed a significant correlation with lower nadir CD4 count (p = 0.003) as well as low-density lipoprotein cholesterol (p = 0.02). No additional significant correlation between vascular reactivity index and the rest of the investigated variables was found. CONCLUSION: Vascular reactivity index, a clinical predictor of endothelial dysfunction, is associated with lower nadir CD4-T cell and low-density lipoprotein cholesterol in HIV-infected men with no history of hypertension or diabetes and before clinical evidence of cardiovascular disease.
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Mogadam et al. (2020) conducted a cohort in HIV infection (n=19). Nadir CD4-T cell count vs. Higher nadir CD4-T cell count was evaluated on Vascular reactivity index (VRI) (R=0.64, p=0.003). Lower nadir CD4-T cell count was significantly correlated with worse endothelial function as measured by vascular reactivity index (p=0.003) in a healthy HIV cohort.
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