Impact of human immunodeficiency virus infection on arterial stiffness and wave reflections in the early disease stages

Abstract

Background: Human immunodeficiency virus (HIV) infection is associated with subclinical inflammation and increased cardiovascular risk. Arterial stiffness and enhanced wave reflections are markers of cardiovascular disease and independent predictors of cardiovascular risk. The effect of HIV infection, per se, on aortic stiffness and wave reflections has not been clearly defined. Methods: We studied 51 adults with a recent HIV infection, free of antiretroviral treatment and AIDS diagnosis, as well as 35 controls matched for age, sex and smoking status. Carotid-femoral pulse wave velocity (PWV) and timing of the reflected wave (Tr) were measured as indices of aortic stiffness, while aortic augmentation index (AIx) and augmented pressure (AP) were measured as indices of wave reflections. Results: While PWV was similar in the two populations, Tr was significantly lower in HIV-infected subjects compared to controls (by 16.5ms, p=0.002). In addition, AIx and AP were decreased (by 6.4%, p=0.048 and by 3.3mmHg, p=0.010, respectively) in subjects with HIV infection. Moreover, HIV-infected patients compared with controls had increased values of hs-CRP [1.37 (0.85–2.53) vs. 0.75 (0.41–1.90) mg/l, p=0.007] and interleukin-6 [1.90 (0.91–3.9) vs. 1.28 (0.80–2.65) pg/ml, p=0.048]. Tr was negatively correlated with hs-CRP (r=−0.283, p=0.010) and interleukin-6 (r=−0.278, p=0.018). Conclusions: Our study provides evidence of decreased wave reflections and similar aortic stiffness, as assessed by PWV, in the early stages of HIV infection in treatment-naive patients compared to controls. Subclinical inflammation and resultant peripheral vasodilatation constitute potential mediators of the whole pathophysiological process.

Keywords

• Acquired immunodeficiency syndrome
• Aortic stiffness
• Cytokines
• Vascular biology
• Wave reflections