Nkeh-Chungag Benedicta N, Goswami Nandu, Engwa Godwill A, Sewani-Rusike Constance R, Mbombela Vuyolwethu, Webster Ingrid, De Boever Patrick, Kessler Harald H, Stelzl Evelyn, Strijdom Hans
Department of Biological and Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University PBX1, 5117 Mthatha, South Africa.
Physiology Division, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Neue Stiftingtalstrasse 6, D-5 A 8036 Graz, Austria.
J Clin Med. 2021 Jan 20;10(3):392. doi: 10.3390/jcm10030392.
Limited information on the effect of antiretroviral treatment (ART) on vascular function in South Africans of African descent living with human immunodeficiency virus (HIV) is available. The relationship between ART, vascular function and cardiovascular risk factors in South Africans of African ancestry with HIV was therefore studied. This cross-sectional study recruited 146 HIV-positive individuals on ART (HIVART), 163 HIV-positive individuals not on ART (HIVART) and 171 individuals without HIV (HIV) in Mthatha, Eastern Cape Province of South Africa. Flow-mediated dilation (FMD) test was performed to assess endothelial function. Anthropometry and blood pressure parameters were measured. Lipid profile, glycaemic indices, serum creatinine as well as CD4 count and viral load were assayed in blood. Urinary albumin to creatinine ratio (ACR) was determined as a marker of cardiovascular risk. Obesity and albuminuria were positively associated with HIV, and HIVART participants had significantly higher HDL cholesterol. Dyslipidaemia markers were significantly higher in hypertensive HIVART participants compared with the controls (HIVART and HIV participants). FMD was not different between HIVART participants and the controls. Moreover, HIVART participants with higher FMD showed lower total cholesterol and LDL cholesterol comparable to that of HIV and HIVART participants. A positive relationship between FMD and CD4 count was observed in HIVART participants. In conclusion, antiretroviral treatment was associated with cardiovascular risk factors, particularly dyslipidaemia, in hypertensive South Africans of African ancestry with HIV. Although, ART was not associated with endothelial dysfunction, flow-mediated dilatation was positively associated with CD4 count in HIV-positive participants on ART.
关于抗逆转录病毒治疗（ART）对南非非洲裔人类免疫缺陷病毒（HIV）感染者血管功能影响的信息有限。因此，研究了南非非洲裔HIV感染者中ART、血管功能和心血管危险因素之间的关系。这项横断面研究在南非东开普省姆塔塔招募了146名接受ART治疗的HIV阳性个体（HIV-ART组）、163名未接受ART治疗的HIV阳性个体（HIV组）和171名未感染HIV的个体（对照组）。进行了血流介导的血管舒张（FMD）试验以评估内皮功能。测量了人体测量学指标和血压参数。检测了血液中的血脂谱、血糖指标、血清肌酐以及CD4细胞计数和病毒载量。测定了尿白蛋白与肌酐比值（ACR）作为心血管风险的标志物。肥胖和蛋白尿与HIV呈正相关，接受ART治疗的参与者的高密度脂蛋白胆固醇显著更高。与对照组（HIV组和HIV-ART组参与者）相比，高血压HIV-ART组参与者的血脂异常标志物显著更高。HIV-ART组参与者与对照组之间的FMD无差异。此外，FMD较高的HIV-ART组参与者的总胆固醇和低密度脂蛋白胆固醇较低，与HIV组和HIV-ART组参与者相当。在HIV-ART组参与者中观察到FMD与CD4细胞计数呈正相关。总之，在南非非洲裔高血压HIV感染者中，抗逆转录病毒治疗与心血管危险因素相关，尤其是血脂异常。虽然ART与内皮功能障碍无关，但在接受ART治疗的HIV阳性参与者中，血流介导的血管舒张与CD4细胞计数呈正相关。
