Key result
HIV infection shows no association with impaired endothelial or vascular function compared to controls.
Why the study?
People living with HIV have increased susceptibility to cardiovascular disease, but the impact of HIV infection and ART on vascular function and cardiovascular risk markers in South Africans is not well characterized.
Does HIV infection affect endothelial and vascular function or cardiovascular risk markers in adults of African descent in South Africa?
Case-Control (n=382)
No
Does HIV infection affect endothelial and vascular function or cardiovascular risk markers in adults of African descent in South Africa?
Absolute Event Rate: 7.44% vs 7.23%
p-value: p=0.75
Despite higher rates of traditional lipid risk factors and tobacco use, effectively treated HIV infection was not associated with worsened macrovascular endothelial function in this South African cohort.
Treated HIV showed no endothelial impairment despite adverse risk factors; extends prior African data but remains hypothesis-generating for CV outcomes.
BACKGROUND: People living with the Human Immunodeficiency Virus (PLHIV) have an increased susceptibility to develop non-communicable diseases such as cardiovascular disease (CVD). Infection with HIV contributes to the development of CVD independent of traditional risk factors, with endothelial dysfunction being the central physiological mechanism. While HIV-related mortality is declining due to antiretroviral treatment (ART), the number of deaths due to CVD is rising in South Africa - the country with the highest number of PLHIV and the world's largest ART programme. The EndoAfrica study was developed to determine whether HIV infection and ART are associated with cardiovascular risk markers and changes in vascular structure and function over 18 months in adults from different provinces of South Africa. This paper describes the rationale, methodology and baseline cohort profile of the EndoAfrica study conducted in the North West Province, South Africa. METHODS: In this case-control study, conducted between August 2017 and June 2018, 382 volunteers of African descent (276 women; 106 men), comprising of 278 HIV infected and 104 HIV free individuals were included. We measured health behaviours, a detailed cardiovascular profile, and performed biomarker analyses. We compared baseline characteristics, blood pressure, vascular function and biochemical markers between those infected and HIV free. RESULTS: ) than that of the HIV free participants. While the cardiovascular profile, flow-mediated dilation and pulse wave velocity did not differ, glycated haemoglobin was lower (p = 0.017) and total cholesterol, high density lipoprotein cholesterol, triglycerides, gamma-glutamyltransferase and tobacco use were higher (all p < 0.047) in PLHIV. CONCLUSION: Despite PLHIV being older, preliminary cross-sectional analysis suggests that PLHIV being treated with ART do not have poorer endothelial or vascular function compared to the HIV free participants. More detailed analyses on the baseline and follow-up data will provide further clarity regarding the cardiovascular profile of South Africans living with HIV.
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Fourie et al. (2020) conducted a case-control in Human Immunodeficiency Virus (HIV) infection (n=382). HIV infection vs. HIV-free controls was evaluated on Endothelial function measured by flow-mediated dilation (FMD) (p=0.75). HIV infection did not significantly impair endothelial or vascular function at baseline, as flow-mediated dilation (7.44% vs 7.23%, p=0.75) and pulse wave velocity did not differ compared to HIV-free controls.
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