Echocardiographic Abnormalities and Associated Factors in a Cohort of Asymptomatic HIV-Infected Patients

Abstract

HIV patients have been reported to have a greater prevalence of echocardiographic abnormalities. We aimed to determine the prevalence of these abnormalities and their associated factors. This was an observational study of a cohort of asymptomatic HIV patients. Data were recorded on factors of cardiovascular interest and those related to HIV infection. All the subjects underwent a transthoracic echocardiogram. The study included 196 patients, 85.2% men, mean age 46.4 years, with a mean duration of HIV infection of 123.8 months and 27.6% with AIDS. Of the patients, 94.4% were on antiretroviral therapy and 92.5% of these had an undetectable viral load. The mean CD4 cell count was 544/mm(3). The following echocardiographic abnormalities were found: left ventricular (LV) hypertrophy 28.6%, LV diastolic dysfunction 19.9%, left atrial (LA) dilatation 7.7%, right ventricular (RV) systolic dysfunction 6.1%, pulmonary hypertension 2.6%, RV dilatation 2%, and (LV) systolic dysfunction 1%. LV hypertrophy was associated with diabetes mellitus (OR 5.3, 95% CI 1.8-15.3; p=0.001), LV diastolic dysfunction with age (OR for each extra 5 years 4.4, 95% CI 4.2-4.6; p=0.0001), obesity (OR 4.07, 95% CI 1.6-10.0; p=0.02), alcohol consumption (OR 2.5, 95% CI 1.07-6.2; p=0.03) and lower CD4 cell count (OR for each 10 CD4 cells less 10.02, 95% CI 10.00-10.04; p=0.008), and RV systolic dysfunction with hypertension (OR 5.4, 95% CI 1.6-18.2; p=0.005). Echocardiographic abnormalities in HIV patients were common, especially LV hypertrophy and diastolic dysfunction. Prospective comparative studies involving the general population are needed to determine the prevalence of HIV infection and its treatment in these abnormalities.

Human Ig knockin mice to study the development and regulation of HIV‐1 broadly neutralizing antibodies

“…One clue supporting the latter possibility has come from follow-up studies that further dissected the regimen, in which specific presentation of the MPER peptide in liposomes i.e. in an orientation similar to that in the HIV-1 virion (in contrast to general multimeric display), and only with MPLA (versus other TLR agonists tested), were both key to induce optimal serum bnAb IgG titers in 2F5 and 4E10 VDJ+VJ mice ((107); H. Verville, L. Verkoczy et al, manuscript in preparation), suggesting a key role for lipid components in overcoming anergy of MPER + bnAbs. An intriguing remaining question regarding overcoming MPER bnAb anergy is whether strength of T H priming and degree of tolerization are related (i.e.…”

Persistent HIV-1 replication is associated with lower antiretroviral drug concentrations in lymphatic tissues

“…Levels of T-cell activation and innate system activation are often higher than that observed in well-matched uninfected adults (5,6). These persistent abnormalities may contribute to abnormal vaccine responses (7,8), a higher than normal incidence of non-AIDS-related cancers (9,10) and increased risk for clinical conditions associated with chronic inflammation (e.g., cardiac disease, clotting disorders, pulmonary hypertension, emphysema, and stroke) (11)(12)(13)(14)(15)(16)(17)(18). Thus, improvements over current approaches to treatment of HIV infection that more fully restore normal immune function might significantly improve health and life expectancy.…”

Human Immunodeficiency Virus and Pulmonary Arterial Hypertension

“…They also mentioned that the prevalence of HIV-related PAH is underestimated since clinical studies tend to include symptomatic patients. Isasti et al confirmed the notion regarding underestimation of the prevalence of PH in a study of 196 HIV-infected individuals who lacked respiratory or cardiac complaints [24, 25]. It was demonstrated that 2.6% of patients did have evidence of PH and 6.1% had right ventricular systolic dysfunction based on echocardiography.…”