Carotid Intima-Media Thickness and Arterial Stiffness in HIV-Infected Patients: The Role of HIV, Antiretroviral Therapy, and Lipodystrophy

Vonderen, Marit G. A. van; Smulders, Yvo M.; Stehouwer, Coen D.A.; Danner, Sven A.; Gundy, Chad M.; Vos, F. Poche-de; Reiss, Peter; Agtmael, Michiel A. van

doi:10.1097/qai.0b013e31819367cd

Cited by 87 publications

(87 citation statements)

References 52 publications

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“…A relationship between increased aortic stiffness and PI treatment in HIV-infected patients has been described in many observational studies, independently of conventional CV risk factors [9,20,36,37]. In our study population, neither HIV-related parameters or PI treatment entered the explicative model of aortic PWV, consistent with recently published results [32].…”

Section: Central Arterial Parameters and Hiv Infectionsupporting

confidence: 81%

“…In addition, we studied a group of middle-aged patients with extremely good virological control in a large number of participants and significant CV prevention implementation (only 13% were active smokers, 20% and 22% were on a statin and anti-hypertensive drugs, respectively). This may contribute to explain the discrepancy with previous studies showing higher PWV values in HIV-positive than in HIV-negative persons [9,36,37]. As age (in association with MAP) is the major determinant of aortic stiffness, the longitudinal follow-up of our study population would provide further evidence about early vascular aging and its determinants in HIV-infected patients with viral suppression.…”

Section: Central Arterial Parameters and Hiv Infectioncontrasting

confidence: 54%

“…Arterial parameters of the study population are summarized in (28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) mmHg, respectively. Median value (IQR) for carotid-femoral PWV in our study population was 8.3(7.5-9.5) m/sec, which was slightly higher than the theoretical carotid-femoral PWV calculated by age category on the basis of MAP [median (IQR): 8.0(7.4-9.1) m/sec].…”

Section: Central and Peripheral Arterial Parametersmentioning

confidence: 99%

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Structural and Functional Arterial Parameters, Immunovirological Control and Vitamin D in HIV-Infected Patients

Yannoutsos¹

2014

J AIDS Clin Res

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Objective: HIV-infected patients still experience higher Cardiovascular (CV) mortality rates, even if an adequate viral suppression is achieved. In addition, vitamin D insufficiency, a common condition in HIV-infected patients, is increasingly associated with CV risk. We therefore aim to investigate relationships between immunological parameters, antiretroviral therapy, plasma vitamin D and arterial parameters, including aortic stiffness and wave reflections, in HIV-infected patients who achieved viral suppression but possibly remain at increased CV risk. Methods:We conducted a cross-sectional study including 178 middle-aged HIV-infected patients. HIV infection was controlled in a large number of participants, representative of a real-world setting. In addition to carotid Intima Media Thickness (IMT), central hemodynamic parameters involved aortic Pulse Wave Velocity (PWV), carotid Augmentation index (AIx) and Pulse Pressure Amplification (PPA) measured noninvasively using applanation tonometry.Results: Aortic PWV was slightly but unsignificantly higher than the theoretical values obtained in general population according to age and blood pressure, and was independent of HIV-related parameters. In univariate and multivariate analyses, carotid AIx was positively correlated with current CD4 T-cell count and PPA was positively correlated with vitamin D, independently of other confounders. No HIV-related parameters or vitamin D entered the multivariate analysis of carotid IMT / plaque. Conclusion:In our chronically treated population, HIV infection was not associated with increased aortic stiffness but with a positive correlation between current CD4 T-cell count and degree of AIx, suggesting that patients with higher CD4 T-cell count may have higher wave reflections. The positive correlation between vitamin D and PPA suggests that vitamin D deficiency may be independently associated with altered central hemodynamics in well controlled HIV-infected patients. These findings should be confirmed in prospective studies.

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Section: Central Arterial Parameters and Hiv Infectionsupporting

confidence: 81%

Section: Central Arterial Parameters and Hiv Infectioncontrasting

confidence: 54%

Section: Central and Peripheral Arterial Parametersmentioning

confidence: 99%

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Structural and Functional Arterial Parameters, Immunovirological Control and Vitamin D in HIV-Infected Patients

Yannoutsos¹

2014

J AIDS Clin Res

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“…6 Although treatment may reduce endothelial activation, it does not seem to ameliorate the effects of HIV infection, thus endothelial dysfunction may persist and promote atherosclerosis, even among those with low viral loads. 9 Carotid intima-media thickness (IMT) is a marker of sub-clinical atherosclerosis and CVD. 10 Abd-Elmoniem et al reported increased IMT's in young adults infected with HIV.…”

mentioning

confidence: 99%

Early vascular aging in the HIV infected: Is arterial stiffness assessment the ideal tool?

Fourie

Schutte

2017

Virulence

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“…Exposure to ART in HIV-infected individuals is associated with thickening of the carotid artery intima and arterial stiffness (153,154) . Recent findings from the Women's Interagency HIV Study and the Multicenter AIDS Cohort found a significant association between HIV-related immunosuppression and increased carotid artery stiffness, independent from the impact of ART or other traditional atherosclerotic risk factors (155) .…”

Section: Carotid Artery Intima Thicknessmentioning

confidence: 99%

Nutrition and the HIV-associated lipodystrophy syndrome

Loonam

Mullen

2012

Nutr. Res. Rev.

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HIV-associated lipodystrophy syndrome (HALS), comprising metabolic and morphological alterations, is a known side effect of highly active antiretroviral therapy (HAART). Evidence for the role of nutrition in the management of the systemic parameters of HALS is currently limited. In the present paper we review the current knowledge base surrounding HALS, focusing particularly on the role of nutrition in mitigating the systemic parameters of the syndrome. Reported prevalence of HALS was found to vary from 9 to 83 % due to lack of a standardised definition, as well as variations in assessment methods and in the study population used. HALS is associated with both morphological (lipoatrophy, lipohypertrophy) and metabolic (dyslipidaemia, glucose intolerance, diabetes, hypertension, endothelial dysfunction and atherosclerosis) alterations, which may occur singly or in combination, and are associated with an increased risk of CVD. HAART-induced adipocyte inflammation, oxidative stress and macrophage infiltration, as well as altered adipocyte function and mitochondrial toxicity, have been shown to be central to the development of HALS. The adipocyte, therefore, represents a plausible target for treatment. Pharmacological and surgical treatment interventions have shown effect. However, their use is associated with numerous adverse effects and complications. Targeted lifestyle interventions may provide a useful alternative for managing HALS owing to their safety and tolerability. A Mediterranean-style diet has been found to be effective in improving the systemic parameters of HALS. Furthermore, the effects of n-3 PUFA supplementation are encouraging and future randomised controlled trials investigating the beneficial effects of n-3 PUFA in HALS are justified.

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Carotid Intima-Media Thickness and Arterial Stiffness in HIV-Infected Patients: The Role of HIV, Antiretroviral Therapy, and Lipodystrophy

Abstract: HIV infection is independently associated with C-IMT and generally increased arterial stiffness. ART use is associated with increased stiffness of the femoral artery.

Cited by 87 publications

References 52 publications

Structural and Functional Arterial Parameters, Immunovirological Control and Vitamin D in HIV-Infected Patients

Structural and Functional Arterial Parameters, Immunovirological Control and Vitamin D in HIV-Infected Patients

Early vascular aging in the HIV infected: Is arterial stiffness assessment the ideal tool?

Nutrition and the HIV-associated lipodystrophy syndrome

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