Aortic stiffness aging is influenced by past profound immunodeficiency in HIV-infected individuals: Results from the EVAS-HIV (EValuation of Aortic Stiffness in HIV-infected individuals)

Luísa H. Maia-Leite, Emmanuel Catez, Anders Boyd, Nabila Haddour, Angelique Curjol, Sylvie Lang, Mabel Nuernberg, Claudine Duvivier, Moise Desvarieux, Miriam Kirstetter, Pierre-Marie Girard, Ariel Cohen, Franck Boccara

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Abstract

Objective: We compared aortic stiffness between HIV-infected and HIV-uninfected individuals and examined the determinants of vascular aging during HIV infection. Methods: Aortic stiffness using carotid-femoral pulse wave velocity (cf-PWV) was evaluated cross-sectionally between HIV-infected individuals and uninfected controls frequency-matched for age and sex, and longitudinally in a subgroup of HIV-infected individuals. Determinants of elevated cf-PWV levels were assessed using logistic regression. Changes in cf-PWV levels during follow-up (mixed-effect linear regression) and risk factors for achieving cf-PWV below (Group 1) or above the median (Group 2) at last follow-up visit were evaluated only in HIV-infected individuals. Results: A total of 133 HIV-infected and 135 HIV-uninfected individuals (mean age: 47.7±8.9 years, 91% men) were enrolled. Median cf-PWV at baseline was similar between HIV-infected individuals and controls [7.5m/s (interquartile range=6.7-8.4) vs. 7.5m/s (interquartile range=6.6-8.4), respectively; P=0.64]. In multivariable analysis, only mean arterial pressure showed significant association with elevated cf-PWV in the overall population (P=0.036). In HIV-infected individuals, elevated cf-PWV was associated with current smoking (P=0.042), and nadir CD4 + T-cell count less than 200 cells/μl (P=0.048). Ninety-one HIV-infected individuals were followed for a mean 7.6±2.0 years. cf-PWV progression was associated with age (P=0.018), mean arterial pressure (P=0.020), and nadir CD4 + T-cell count (P=0.005). Patients from Group 2 had higher baseline waist circumference, pulse pressure, and nadir CD4 + T-cell count less than 200 cells/μl. Conclusion: We observed no difference in aortic stiffness between HIV-infected and controls. Moreover, aortic stiffness aging was independently associated with past severe immunodeficiency, along with other traditional risk factors. Our results call for early antiretroviral initiation.
Original languageEnglish
Pages (from-to)1338-1346
Number of pages9
JournalJournal of Hypertension
Volume34
Issue number7
DOIs
Publication statusPublished - 1 Jul 2016
Externally publishedYes

Keywords

  • Adult
  • Aging/physiology
  • Aorta/physiopathology
  • Arterial Pressure
  • CD4 Lymphocyte Count
  • Case-Control Studies
  • Cross-Sectional Studies
  • Disease Progression
  • Female
  • HIV Infections/immunology
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Pulse Wave Analysis
  • Risk Factors
  • Smoking
  • Vascular Stiffness

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