Key result
Nine months of antiretroviral therapy significantly reduced aortic stiffness, measured by pulse wave velocity, by a mean of 0.26 m/s compared to baseline in newly diagnosed people living with HIV.
Why the study?
Aortic stiffness predicts CVD and is elevated at HIV diagnosis, but the prospective effect of contemporary ART on aortic stiffness in newly diagnosed PLWH was unknown.
Does contemporary antiretroviral therapy improve aortic stiffness in newly diagnosed, treatment-naïve people living with HIV?
Cohort (n=73)
Does contemporary antiretroviral therapy improve aortic stiffness in newly diagnosed, treatment-naïve people living with HIV?
Mean Difference: -0.26 (95% CI -0.45–-0.07)
Absolute Event Rate: 5.69% vs 5.93%
p-value: p=0.01
Initiation of contemporary antiretroviral therapy in newly diagnosed HIV patients is associated with a short-term improvement in aortic stiffness, suggesting reversible functional vascular dysfunction.
Contemporary antiretroviral therapy was associated with reduced aortic stiffness in new HIV diagnoses; hypothesis-generating and requires randomized confirmation before practice change.
Background: People living with HIV (PLWH) are at increased risk of cardiovascular disease (CVD). Aortic stiffness measured with carotid-femoral pulse wave velocity (PWV) is a validated predictor of CVD and has been shown to be elevated in PLWH at HIV diagnosis. Objectives: To prospectively evaluate the effect of 9 months of contemporary antiretroviral therapy (ART) on aortic stiffness in newly diagnosed PLWH. Methods: A group of ART-naïve PLWH with modest cardiovascular risk and without known CVD were recruited at the time of HIV diagnosis. Aortic stiffness was measured using carotid-femoral PWV (ViCorder, Skidmore Medical, UK) before ART initiation and after 9 months on treatment. Results: Seventy-three participants were analysed (mean age 32 ± 7 years; 45% female). PWV decreased significantly after 9 months of ART (5.93 ± 1.0 vs. 5.69 ± 1.0 m/s; p = 0.01) with increased aortic distensibility (0.36 [IQR 0.30 to 0.46] vs. 0.40 [IQR 0.34 to 0.50] mmHg−1; p = 0.02). The reduction in PWV remained significant after adjustment for covariates (mean change −0.26 m/s; 95% CI −0.07 to −0.45; p = 0.01). Conclusions: Aortic stiffness improved in a group of newly diagnosed PLWH after ART initiation at 9 months, in keeping with a modifiable component of HIV-associated vascular dysfunction. The findings are consistent with reversible functional vascular abnormality, potentially mediated by changes in vasomotor tone, although it is unknown if this effect will be sustained long-term. The trajectory of aortic stiffness in PLWH and the mechanisms that underpin vasomotor tone require further study.
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Robbertse et al. (2026) conducted a cohort in HIV (n=73). Antiretroviral therapy (ART) vs. Baseline (pre-ART) was evaluated on Aortic stiffness measured by carotid-femoral pulse wave velocity (PWV) (MD -0.26, 95% CI -0.45 to -0.07, p=0.01). Nine months of antiretroviral therapy significantly reduced aortic stiffness, measured by pulse wave velocity, by a mean of 0.26 m/s compared to baseline in newly diagnosed people living with HIV.
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