Aortic stiffness and central hemodynamics in treatment naïve HIV infection: A cross-sectional study

Abstract

Background: Human immunodeficiency virus (HIV) infection is associated with a greater risk of cardiovascular disease (CVD). HIV infection causes a chronic inflammatory state and increases oxidative stress which can cause endothelial dysfunction and arterial stiffness. Aortic stiffness measured by carotid femoral-pulse wave velocity (cfPWV) and central hemodynamics are independent cardiovascular risk factors and have the prognostic ability for CVD. We assessed cfPWV and central hemodynamics in young individuals with recent HIV infection diagnosis not receiving antiretroviral therapy. We hypothesized that HIV individuals would present greater cfPWV and central hemodynamics (central systolic blood pressure and pulse pressure) compared to uninfected controls. Methods. We recruited 51 treatment naïve HIV individuals (HIV(+)) without previous CVD and 51 age- and sex-matched controls (HIV(-)). We evaluated traditional CVD risk factors including metabolic profile, blood pressure (BP), smoking, and immune state. Arterial stiffness and central hemodynamics were evaluated by cfPWV, central systolic BP and central pulse pressure (cPP) via applanation tonometry. Results. HIV(+) individuals presented a greater prevalence of smoking, reduced high density lipoprotein cholesterol, and body mass index. 65.9% of HIV(+) individuals exhibited lymphocytes <500 cell/µL. There was no difference in brachial or central BP between groups; however, HIV(+) individuals showed significantly lower cPP. We observed a greater cfPWV (mean difference= 0.5 m/s; p<0.01) in HIV(+) compared to controls, even after adjusting for heart rate, mean arterial pressure and smoking. Conclusion: In the early stages of infection, non-treated HIV individuals present a greater prevalence of traditional CVD risk factors, arterial stiffness, and normal or decreased central hemodynamics.