The following is a summary of “Coronary Microcirculatory Dysfunction in People With HIV and Its Association With Antiretroviral Therapy,” published in the November 2023 issue of Cardiology by Huck et al.

In this investigation, the focus was on individuals with HIV and the impact of specific antiretroviral therapies on their coronary microvascular health. Positron emission tomography (PET) was utilized to assess myocardial blood flow reserve (MBFR), a recognized measure of coronary microvascular function and cardiovascular risk. A comparison was made between individuals with HIV (PWH) and matched non-HIV individuals to analyze MBFR. The study also evaluated whether switching from dolutegravir/lamivudine/abacavir to bictegravir/emtricitabine/tenofovir alafenamide (TAF) would improve MBFR. The analysis involved 37 PWH, matching them with 75 non-HIV individuals based on cardiovascular risk factors. PWH displayed lower stress myocardial blood flow and MBFR than their non-HIV counterparts.

Additionally, a subset of 25 PWH under the dolutegravir/lamivudine/abacavir regimen underwent PET imaging before and after switching to bictegravir/emtricitabine/TAF. The study discovered that while MBFR remained unchanged after the regimen switch, there was a notable increase in individuals with impaired MBFR at baseline, signifying potential improvement in their coronary microvascular function. These findings highlight the diminished coronary microvascular function in PWH compared to those without HIV and suggest limited improvements in MBFR after transitioning from dolutegravir/lamivudine/abacavir to bictegravir/emtricitabine/TAF, except for those with initially impaired MBFR.

Source: ahajournals.org/doi/10.1161/JAHA.123.029541