CARDIOVASCULAR STATUS REFERENCE VALUES OF RECENTLY DIAGNOSED AND NAÏVE TO TREATMENT HUMAN IMMUNODEFICIENCY VIRUS (HIV) PATIENTS. A PILOT STUDY. (April 2021) - Triantafyllidi, Helen
Abstract: Objective: HIV infection is a well recognized risk factor for cardiovascular (CV) disease. Virus induced chronic inflammation plays a key role in the development of early CV disease. The aim of this study is to explore the baseline CV status of recently diagnosed and naïve to treatment HIV patients regarding arterial blood pressure parameters, target organ damage indices as well as aerobic capacity (AC). Design and method: Forty two (42) recently diagnosed and naïve HIV patients were evaluated regarding office and central blood pressure (SBP/DBP), carotid-femoral aortic stiffness estimated by PWV and endothelial function measured by endothelial glycocalyx integrity. Increased perfusion boundary region (PBR) of the sublingual arterial microvessels (ranged from 5–9 micrometers) Using Sideview Darkfield imaging (Microscan, Glycocheck) was measured as a non-invasive accurate index of reduced EG thickness. Finally AC status was evaluated after a maximal cardiopulmonary exercise test (CPET). No one patient had ever received any treatment for HIV or any cardiovascular disease. Results: HIV patients were mostly males (38 men, 90%), young (mean age = 37 + 10 years), smokers (21, 42%) and normotensives (office SBP/DBP = 124 + 13/76 + 10 mmHg and central SBP/DBP = 116 + 12/77 + 10 mmHg). PWV was estimated as 9.2 + 1.7 m/sec. Endothelial glycocalyx intergrity was measured as PBR5–9 = 1.2 + 0.2 micrometers. During maximum aerobic CPET, HIV patients achieved 8 + 2 METS and 28 + 6 ml/kg/min peak VO2 which corresponds to 80 + 14% of peak VO2 predicted. Their SBP was measured as 112 + 10 mmHg at exercise initiation and 169 + 22 mmHg at peak exercise. Two male patients (5%) had a hypertensive response during CPET defined as SBP > 210 mmHg. Conclusions: It seems that recently diagnosed naïve HIV patients have a CV status similar to which corresponds to their age. We are going to re-evaluate those patients, one and three years after HIV treatment initiation, in order to explore any early differences regarding their CV status.