Relationship between Endothelial Function, Antiretroviral Treatment and Cardiovascular Risk Factors in HIV Patients of African Descent in South Africa: A Cross-Sectional Study

Abstract

Limited information on the effect of antiretroviral treatment (ART) on vascular function in South Africans of African descent living with human immunodeficiency virus (HIV) is available. The relationship between ART, vascular function and cardiovascular risk factors in South Africans of African ancestry with HIV was therefore studied. This cross-sectional study recruited 146 HIV-positive individuals on ART (HIV+ART+), 163 HIV-positive individuals not on ART (HIV+ART−) and 171 individuals without HIV (HIV−) in Mthatha, Eastern Cape Province of South Africa. Flow-mediated dilation (FMD) test was performed to assess endothelial function. Anthropometry and blood pressure parameters were measured. Lipid profile, glycaemic indices, serum creatinine as well as CD4 count and viral load were assayed in blood. Urinary albumin to creatinine ratio (ACR) was determined as a marker of cardiovascular risk. Obesity and albuminuria were positively associated with HIV, and HIV+ART+ participants had significantly higher HDL cholesterol. Dyslipidaemia markers were significantly higher in hypertensive HIV+ART+ participants compared with the controls (HIV+ART− and HIV− participants). FMD was not different between HIV+ART+ participants and the controls. Moreover, HIV+ART+ participants with higher FMD showed lower total cholesterol and LDL cholesterol comparable to that of HIV− and HIV+ART− participants. A positive relationship between FMD and CD4 count was observed in HIV+ART+ participants. In conclusion, antiretroviral treatment was associated with cardiovascular risk factors, particularly dyslipidaemia, in hypertensive South Africans of African ancestry with HIV. Although, ART was not associated with endothelial dysfunction, flow-mediated dilatation was positively associated with CD4 count in HIV-positive participants on ART.

A Pilot Study: Hypertension, Endothelial Dysfunction and Retinal Microvasculature in Rheumatic Autoimmune Diseases

“…Flow-mediated dilatation (FMD), which is the standard method used to non-invasively assess endothelial cell reactivity will be incorporated in future studies [ 80 , 81 , 82 , 83 ].…”

Autoimmune Rheumatic Diseases and Vascular Function: The Concept of Autoimmune Atherosclerosis

“…Hence, ADMA contributes towards dysfunction of endothelium, and consecutively, vessel diseases [ 140 , 141 ]. Current literature indicates that endothelial dysfunction is an early sign of atherosclerosis and all cardiovascular events and future diseases [ 142 , 143 ].…”

“…The measurements of endothelial dysfunction (vascular function) are important, as they are considered early predictors of cardiovascular risk, future morbidity, and mortality [ 143 ]. Mortality can be increased due to cardiovascular diseases like myocardial infarction and cerebrovascular stroke [ 143 ].…”

“…The measurements of endothelial dysfunction (vascular function) are important, as they are considered early predictors of cardiovascular risk, future morbidity, and mortality [ 143 ]. Mortality can be increased due to cardiovascular diseases like myocardial infarction and cerebrovascular stroke [ 143 ]. Assessment of vascular function can be done by showing the arteries themselves directly, which means we measure its direct function or can be indirect with measuring blood marker, which denotes their function.…”

Assessment of the impact of HIV infection and anti-retroviral treatment on the cardiometabolic health of pregnant mothers and their offspring (ARTMOMSBABES)

“…In South Africa, the prevalence of CVD risk factors in HIV continues to rise creating a major public health concern for the country [ 15 , 16 ]. HIV/AIDS seems to be on a collision course with a rapidly increasing burden of cardiovascular risk factors and disease in this population [ 17 – 19 ]. Indeed it is projected that by 2030, about 84% of HIV-infected patients will be affected by at least one non-communicable disease with over one-third of HIV patients having three or more non-communicable diseases [ 20 ].…”