Endothelial Glycocalyx Integrity in Treatment-Naïve People Living with HIV before and One Year after Antiretroviral Treatment Initiation
Paraskevi C. Fragkou,
Ignatios Ikonomidis,
Dimitrios Benas,
Dimitra Kavatha,
Charalampos D. Moschopoulos,
Konstantinos Protopapas,
Gavriella Kostelli,
John Thymis,
Dionysia Mpirmpa,
Irene Galani,
Maria Tsakona,
Chrysanthi Oikonomopoulou,
George Theocharous,
Vassilis G. Gorgoulis,
Parisis Gallos,
Sotirios Tsiodras,
Anastasia Antoniadou,
Antonios Papadopoulos,
Helen Triantafyllidi
Affiliations
Paraskevi C. Fragkou
First Department of Critical Care and Pulmonary Services, Evangelismos Hospital, Athens Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece
Ignatios Ikonomidis
Second Department of Cardiology, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
Dimitrios Benas
Second Department of Cardiology, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
Dimitra Kavatha
Fourth Department of Internal Medicine, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
Charalampos D. Moschopoulos
Fourth Department of Internal Medicine, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
Konstantinos Protopapas
Fourth Department of Internal Medicine, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
Gavriella Kostelli
Second Department of Cardiology, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
John Thymis
Second Department of Cardiology, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
Dionysia Mpirmpa
Second Department of Cardiology, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
Irene Galani
Fourth Department of Internal Medicine, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
Maria Tsakona
Fourth Department of Internal Medicine, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
Chrysanthi Oikonomopoulou
Fourth Department of Internal Medicine, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
George Theocharous
Molecular Carcinogenesis Group, Department of Histology and Embryology, Athens Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
Vassilis G. Gorgoulis
Molecular Carcinogenesis Group, Department of Histology and Embryology, Athens Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
Parisis Gallos
Computational Biomedicine Laboratory, Department of Digital Systems, University of Piraeus, 18536 Piraeus, Greece
Sotirios Tsiodras
Fourth Department of Internal Medicine, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
Anastasia Antoniadou
Fourth Department of Internal Medicine, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
Antonios Papadopoulos
Fourth Department of Internal Medicine, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
Helen Triantafyllidi
Second Department of Cardiology, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
Endothelial glycocalyx (EG) derangement has been associated with cardiovascular disease (CVD). Studies on EG integrity among people living with HIV (PLWH), are lacking. We conducted a prospective cohort study among treatment-naïve PLWH who received emtricitabine/tenofovir alafenamide, combined with either an integrase strand transfer inhibitor (INSTI, dolutegravir, raltegravir or elvitegravir/cobicistat), or a protease inhibitor (PI, darunavir/cobicistat). We assessed EG at baseline, 24 (±4) and 48 (±4) weeks, by measuring the perfused boundary region (PBR, inversely proportional to EG thickness), in sublingual microvessels. In total, 66 consecutive PLWH (60 (90.9%) males) with a median age (interquartile range, IQR) of 37 (12) years, were enrolled. In total, 40(60.6%) received INSTI-based regimens. The mean (standard deviation) PBR decreased significantly from 2.17 (0.29) μm at baseline to 2.04 (0.26) μm (p = 0.019), and then to 1.93 (0.3) μm (p < 0.0001) at 24 (±4) and 48 (±4) weeks, respectively. PBR did not differ among treatment groups. PLWH on INSTIs had a significant PBR reduction at 48 (±4) weeks. Smokers and PLWH with low levels of viremia experienced the greatest PBR reduction. This study is the first to report the benefit of antiretroviral treatment on EG improvement in treatment-naïve PLWH and depicts a potential bedside biomarker and therapeutic target for CVD in PLWH.
