Individuals living with HIV are at an increased risk of cardiovascular disease, with inflammation contributing to the access risk. This study aims to investigate whether higher levels of viral persistence are associated with an increased risk of atherosclerosis defined by a change in carotid artery intima-media thickness (IMT) over time.

This cohort study included a total of 152 participants living with HIV. The researchers examined cell-associated HIV DNA and RNA, along with a change in IMT. The outcomes were adjusted for demographics, HIV-related factors, and cardiovascular risk factors. The primary outcome of the study was carotid IMT measured at baseline.

The findings suggested that older age, smoking, higher low-density LDL-C levels, higher interleukin 6 levels, and medications for hypertension were associated with higher baseline mean IMT. It was also found that cell-associated HIV DNA and HIV RNA levels were not associated with mean IMT. The levels of HIV RNA and HIV DNA were significantly associated with annual carotid artery IMT progression and incident plaque.

The research concluded that the measurements of the viral persistence in patients with treated HIV disease were independently linked to incident carotid plaque development. The findings also confirmed that the size and transcriptional activity of the HIV reservoir could also be a contributor to HIV-related atherosclerosis.