Short Communication High Risk of Endothelial Dysfunction in HIV Individuals May Result from Deregulation of Circulating Endothelial Cells and Endothelial Progenitor Cells

Abstract

Endothelial progenitor cells (EPC) and circulating endothelial cells (CEC) have recently been considered as biomarkers of cardiovascular risk (CVDR) in healthy subjects. The impact of HIV infection on these cells is not well known. A case-control study was conducted in 15 antiretroviral-naive HIV(+) patients and 15 HIV-negative controls. The quantitative profile of CEC and EPC differed significantly in HIV(+) and HIV(-) subjects. HIV(+) subjects had significantly more CEC and less EPC than HIV(-) controls. A quantitative impairment in the balance of the CEC and EPC might contribute to the increased subclinical CVDR in HIV(+) patients.

Is the atherosclerotic process accentuated under conditions of HIV infection, antiretroviral therapy, and protease inhibitor exposure? Meta-analysis of the markers of arterial structure and function

“…Second, HIV may hyperactivate T cells, which aggravate the inflammatory process, resulting in endothelial dysfunction [71]. On the other hand, the self-healing function of the endothelium may be damaged owing to the absence of endothelial progenitor cells during HIV infection [72]. Thus the bioactivity of nitric oxide is impaired, reflected by the reduction in FMD.…”

Low Levels of Endothelial Progenitor Cells and Their Association with Systemic Inflammation and Monocyte Activation in Older HIV-Infected Men

“…Disturbances in vascular reparative capacity, as measured by the number of circulating endothelial progenitor cells (EPCs), have been suggested as a potential driver of endothelial dysfunction in HIV infection. [4][5][6] EPCs are bone marrowderived cells characterized by having cellular markers of both hematopoietic immaturity 7 and endothelial commitment. 8 Physiologically, EPCs are released from the bone marrow into the circulation after vascular injury and contribute to endothelial repair.…”

Cardiac involvement in HIV-positive patients

“…In HIV-positive patients, the exact mechanisms whereby smoking increases the risk of cardiovascular events are yet to be determined, 21 but endothelial damage appears to be the cornerstone of heart disease in HIV 22 and it has become apparent that the effect of smoking can augment the damage produced by the virus itself, the immune response of the host, 23 or by potential toxicity of older drugs used in the treatment of HIV infection. 24 Furthermore, recent studies have shown that the population-attributable risk of death associated with smoking is higher (61.5%) among HIV-positive patients compared to controls (34.2%), postulating that in this particular category or patients, more life-years are lost to smoking than to HIV.…”