Antiretroviral treatment and time since HIV-1 diagnosis are associated with large artery stiffness in sub-Saharan African HIV-1 patients

Titus F. Msoka; Gary P. Van Guilder; Yvo M. Smulders; Marceline van Furth; John A. Bartlett; Michiel A. van Agtmael

doi:10.1016/j.artres.2016.09.002

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Volume 16, Issue C, December 2016, Pages 34 - 41

Antiretroviral treatment and time since HIV-1 diagnosis are associated with large artery stiffness in sub-Saharan African HIV-1 patients

Authors

Titus F. Msoka^a, Gary P. Van Guilder^b, Yvo M. Smulders^c, Marceline van Furth^d, John A. Bartlett^e, Michiel A. van Agtmael^c^{, *}

^aKilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania

^bDepartment of Health & Nutritional Sciences, Box 2203 SAB 116, South Dakota State University, Brookings, SD 57007, United States

^cDepartment of Internal Medicine, VU University Medical Center, Postbus 7057, 1007 MB Amsterdam, The Netherlands

^dDepartment of Pediatric Infectious Diseases and Immunology, VUmc University Medical Center, Amsterdam, The Netherlands

^eDivision of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, and Duke Global Health Institute, 310 Trent Drive, Durham, NC 27708, United States

^*Corresponding author. Department of Internal Medicine, VU University Medical Center, Postbus 7057, 1007 MB Amsterdam, The Netherlands. E-mail addresses: ftitus2001@yahoo.co.uk (T.F. Msoka), Agtmael@vumc.nl (M.A. van Agtmael).

Corresponding Author

Michiel A. van Agtmael

Received 16 May 2016, Revised 6 September 2016, Accepted 7 September 2016, Available Online 3 October 2016.

DOI: 10.1016/j.artres.2016.09.002 How to use a DOI?
Keywords: Non-nucleoside reverse transcriptase inhibitors; Nucleoside reverse transcriptase inhibitors; HIV; Aortic stiffness; Aortic pulse wave velocity; Augmentation index; Tanzania
Abstract: Background: HIV-1 infection in northern populations is associated with increased large artery stiffness, both in the absence and presence of combination antiretroviral treatment (cART). It is unclear if similar changes occur in sub-Sahara African HIV-infected persons. The study aimed to determine whether HIV-1 infection with and without cART is associated with large artery stiffness in a cohort of HIV-1-infected patients in Tanzania.

Methods: In this cross-sectional study, 146 subjects were recruited: 40 uninfected controls, 51 HIV-1-infected untreated persons, and 55 on cART for at least 12 months. Patients were screened for history of hepatic, renal, haematological or cardiovascular disease, diabetes, dyslipoproteinaemia, and hypertension. Following screening, 4 untreated and 21 cART HIV-1 patients were excluded; leaving 47 HIV-1-infected untreated and 34 cART patients to be studied. cART included first line treatment: lamivudine/zidovudine with nevirapine or efavirenz. Large artery stiffness was assessed using applanation tonometry via pulse wave analysis to determine aortic pulse wave velocity (aPWV) and augmentation index corrected to a heart rate of 75 bpm (AIx@HR75).

Results: Aortic PWV was higher (p = 0.017) in the HIV-1-infected patients on cART (aPWV: 8.2 ± 1.8 m/s) vs. untreated patients (7.3 ± 1.5 m/s) and independent of blood pressure differences. AIx@HR75 was significantly increased in cART HIV-1 (29 ± 8%) vs. untreated HIV-1 patients (23 ± 10%; p = 0.038) and controls (23 ± 10%; p = 0.032). Duration of HIV-1 and cART were independent predictors of arterial stiffening in HIV-1 patients.

Conclusions: The surrogate markers for arterial stiffness suggest an increased cardiovascular risk in sub-Saharan African HIV-1 patients on first line therapy.
Open Access: This is an open access article distributed under the CC BY-NC license.

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Journal: Artery Research
Volume-Issue: 16 - C
Pages: 34 - 41
Publication Date: 2016/10/03
ISSN (Online): 1876-4401
ISSN (Print): 1872-9312
DOI: 10.1016/j.artres.2016.09.002 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC license.

Cite this article

ris enw bib

TY  - JOUR
AU  - Titus F. Msoka
AU  - Gary P. Van Guilder
AU  - Yvo M. Smulders
AU  - Marceline van Furth
AU  - John A. Bartlett
AU  - Michiel A. van Agtmael
PY  - 2016
DA  - 2016/10/03
TI  - Antiretroviral treatment and time since HIV-1 diagnosis are associated with large artery stiffness in sub-Saharan African HIV-1 patients
JO  - Artery Research
SP  - 34
EP  - 41
VL  - 16
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2016.09.002
DO  - 10.1016/j.artres.2016.09.002
ID  - Msoka2016
ER  -

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