Department of Physiology, University of Ghana Medical School, Accra, Ghana.
Department of Physician Assistant Studies, Central University, Accra, Ghana.
Libyan J Med. 2023 Dec;18(1):2215636. doi: 10.1080/19932820.2023.2215636.
Human immunodeficiency virus (HIV) infection is associated with increased cardiovascular diseases (CVDs) even in patients with viral suppression by combination antiretroviral therapy (cART). Arterial stiffness is an independent predictor of CVDs in diseased individuals and the general population. Cardio-ankle vascular index (CAVI) is an index of arterial stiffness that has been shown to predict target organ damage. CAVI is less studied in HIV patients. We compared the levels of arterial stiffness using CAVI and associated factors among cART-treated and cART-naïve HIV patients to those of non-HIV controls. In a case-control design, 158 cART-treated HIV patients, 150 cART-naïve HIV patients and 156 non-HIV controls were recruited from a periurban hospital. We collected data on CVD risk factors, anthropometric characteristics, CAVI, and fasting blood samples to measure plasma glucose, lipid profile, and CD4+ cell counts. Metabolic abnormalities were defined using the JIS criteria. CAVI increased in cART-treated HIV patients compared to cART-naïve HIV patients and non-HIV controls (7.8 ± 1.4 vs 6.6 ± 1.1 vs 6.7 ± 1.4 respectively, < 0.001). CAVI was associated with metabolic syndrome in non-HIV controls [OR (95% CI) = 2.14 (1.04-4.4), = 0.039] and cART-naïve HIV patients [1.47 (1.21-2.38), = 0.015], but not in cART-treated HIV patients [0.81 (0.52-1.26), = 0.353]. In cART-treated HIV patients, a tenofovir (TDF)-based regimen (β = -0.46, = 0.023) was associated with decreased CAVI and decreased CD4+ cell count (β = -0.23, = 0.047) was associated with increased CAVI. In a periurban hospital in Ghana, compared to non-HIV controls or cART-naïve HIV patients, cART-treated HIV patients had increased arterial stiffness measured as CAVI. CAVI is associated with metabolic abnormalities in non-HIV controls and cART-naïve HIV patients, but not in cART-treated HIV patients. Patients on TDF-based regimens had decreased CAVI.
人类免疫缺陷病毒 (HIV) 感染即使在接受联合抗逆转录病毒治疗 (cART) 的病毒抑制患者中也与心血管疾病 (CVD) 的发生风险增加有关。动脉僵硬度是疾病患者和普通人群中 CVD 的独立预测因子。心血管踝血管指数 (CAVI) 是动脉僵硬度的指标，已被证明可以预测靶器官损伤。CAVI 在 HIV 患者中的研究较少。我们比较了接受 cART 治疗和未接受 cART 治疗的 HIV 患者以及非 HIV 对照组的 CAVI 水平和相关因素。在病例对照设计中，我们从一家城郊医院招募了 158 名接受 cART 治疗的 HIV 患者、150 名未接受 cART 治疗的 HIV 患者和 156 名非 HIV 对照组。我们收集了 CVD 危险因素、人体测量特征、CAVI 和空腹血样的数据，以测量血浆葡萄糖、血脂谱和 CD4+细胞计数。使用 JIS 标准定义代谢异常。与未接受 cART 治疗的 HIV 患者和非 HIV 对照组相比，接受 cART 治疗的 HIV 患者的 CAVI 增加（分别为 7.8 ± 1.4、6.6 ± 1.1 和 6.7 ± 1.4，<0.001）。CAVI 与非 HIV 对照组的代谢综合征相关[比值比（95%CI）=2.14（1.04-4.4），=0.039]和未接受 cART 治疗的 HIV 患者[1.47（1.21-2.38），=0.015]，但与接受 cART 治疗的 HIV 患者无关[0.81（0.52-1.26），=0.353]。在接受 cART 治疗的 HIV 患者中，基于替诺福韦（TDF）的方案（β=-0.46，=0.023）与 CAVI 降低相关，而 CD4+细胞计数降低（β=-0.23，=0.047）与 CAVI 升高相关。在加纳的一家城郊医院，与非 HIV 对照组或未接受 cART 治疗的 HIV 患者相比，接受 cART 治疗的 HIV 患者的动脉僵硬度（以 CAVI 衡量）增加。CAVI 与非 HIV 对照组和未接受 cART 治疗的 HIV 患者的代谢异常相关，但与接受 cART 治疗的 HIV 患者无关。接受 TDF 为基础的方案的患者 CAVI 降低。
