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HIV-related immunosuppression associated with increased carotid artery stiffness

Seaberg E. Stroke. 2010;doi:10.1161/strokeaha.110.583856.

Issue: October 2010

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Advanced HIV-related immunosuppression was recently linked with increased carotid arterial stiffness independent from the effects of traditional atherosclerosis risk factors in a new study appearing in Stroke.

Researchers obtained this finding by performing high-resolution B-mode ultrasound to determine the carotid arterial distensibility of HIV-infected and HIV-uninfected participants of the Women’s Interagency HIV Study (n=1,865 women) and the Multicenter AIDS Cohort Study (n=924 men). They then evaluated the relationship between distensibility and HIV infection, CD4+ cell count and exposure to antiretroviral therapy adjusted for demographic, behavioral and clinical characteristics with generalized estimating equations.

According to their findings, among HIV-infected patients, distensibility was 4.3% lower (95% CI, –7.4% to –1.1%) vs. uninfected participants. Additionally, for HIV-infected participants with less than 200 CD4+ cells, distensibility was 10.5% lower (95% CI, –14.5% to –6.2%) vs. HIV-uninfected participants, which did not differ significantly by cohort or race. Use of antiretroviral therapy was independently related to lower distensibility among Multicenter AIDS Cohort Study participants, but not among those in the Women’s Interagency HIV Study.

“Carotid arterial distensibility was significantly lower in HIV-infected vs. HIV-uninfected participants after adjusting for the demographic, behavioral and clinical characteristics of the study population,” the researchers concluded. “The mechanisms underlying these findings remain unknown, but these results suggest that the etiologic pathways may be independent from traditional atherosclerosis risk factors. Our study contributes to a growing volume of research supporting the hypothesis that HIV-related immunosuppression impacts the risk of CVD and underscores the need for further exploration of CVD risk among persons infected with HIV.”

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