Effects of HIV Infection on Arterial Endothelial Function: Results From a Large Pooled Cohort Analysis. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Stein, James H.; Kime, Noah; Korcarz, Claudia E.; Ribaudo, Heather; Currier, Judith S.; Delaney, Joseph C.
• Is Part Of: Arteriosclerosis, thrombosis, and vascular biology. Volume 41:Issue 1(2021)
• Publication Date: 2021-01
• Subjects: arteries -- cardiovascular diseases -- creatinine -- human immunodeficiency virus -- viremia; Arteriosclerosis -- Periodicals; Thrombosis -- Periodicals; Blood-vessels -- Pathophysiology -- Periodicals; Electronic journals; 616.13
• DOI: 10.1161/ATVBAHA.120.315435
• Languages: English
• ISSNs: 1079-5642

Abstract

Abstract : Objective: To determine the effects of HIV serostatus and disease severity on endothelial function in a large pooled cohort study of people living with HIV infection and HIV− controls. Approach and Results: We used participant-level data from 9 studies: 7 included people living with HIV (2 treatment-naïve) and 4 had HIV− controls. Brachial artery flow-mediated dilation (FMD) was measured using a standardized ultrasound imaging protocol with central reading. After data harmonization, multiple linear regression was used to examine the effects of HIV− serostatus, HIV disease severity measures, and cardiovascular disease risk factors on FMD. Of 2533 participants, 986 were people living with HIV (mean 44.4 [SD 11.8] years old) and 1547 were HIV− controls (42.9 [12.2] years old). The strongest and most consistent associates of FMD were brachial artery diameter, age, sex, and body mass index. The effect of HIV+ serostatus on FMD was strongly influenced by kidney function. In the highest tertile of creatinine (1.0 mg/dL), the effect of HIV+ serostatus was strong (β=−1.59% [95% CI, −2.58% to −0.60%], P =0.002), even after covariate adjustment (β=−1.36% [95% CI, −2.46% to −0.47%], P =0.003). In the lowest tertile (0.8 mg/dL), the effect of HIV+ serostatus was strong (β=−1.90% [95% CI, −2.58% to −1.21%], P <0.001), but disappeared after covariate adjustment. HIV RNA viremia, CD4+ T-cell count, and use of antiretroviral therapy were not meaningfully associated with FMD. Conclusions: The significant effect of HIV+ serostatus on FMD suggests that people living with HIV are at increased cardiovascular disease risk, especially if they have kidney disease. Abstract : Supplemental Digital Content is available in the text.