Kardiologia polska 2017 05 29() doi 10.5603/KP.a2017.0075
Many factors are associated with HIV (the human immunodeficiency virus) patients having a greater risk of cardiovascular diseases. HIV damages vessel endothelium through chronic inflammation which combined with dyslipidemia, arterial hypertension and antiretroviral therapy leads to the progression of atherosclerotic changes.
Our goal was to determine if a CD4 nadir along with immunologic, inflammatory, biochemical and metabolic markers can be associated with higher vessel stiffness and therefore an increased risk of cardiovascular diseases in patients undergoing antiretroviral therapy for HIV.
Endothelial damage was evaluated in 20 patients (including 4 female) during successful antiretroviral therapy. We assessed the endothelial stiffness by recording the reactive hyperemia of peripheral arteries using the Endo-PAT2000 (ITAMAR®) device. This device allowed us to measure the arterial tonometry and to determine the augmentation index for a pulse rate of 75/minute (AI@75). We set the normal value for vessel stiffness at RHI>1.67 (Reactive Hyperemia Index) as recommended by the manufacturer. Additionally, we recorded the length of antiretroviral therapy, number of CD4 lymphocytes, CD4 nadir, HIV viremia and biochemical, and immunologic results. Finally, we compared patients with normal and dysfunctional endothelium.
The only parameter significantly differentiating between group with and without endothelium dysfunction was platelet (PLT) count (p = 0,012).
We were not able to confirm the significance of a CD4 nadir in progression of endothelial stiffness in HIV patients. However, PLT values could be an important complementary marker for assessing the risk for cardiovascular disease amongst HIV patients undergoing antiretroviral treatment.