HIV
Positive Patients Have Significant Impairment of Endothelial Function, especially
Injection Drug Users and Those with Elevated HIV Viral Load Several
reports have suggested an increased risk of coronary disease
in HIV positive patients receiving protease
inhibitors (PIs). Impaired endothelium-dependent vasodilation is a commonly accepted surrogate marker of
coronary atherosclerotic disease.
The
present study evaluated the effect of HIV infection and
antiretroviral treatment on endothelial vasomotor function, by
assessing brachial artery flow-mediated dilation (FMD).
A
total of 75 HIV-infected patients were compared with 223
control subjects who were presumed to be HIV uninfected.
HIV-infected patients were older, were more likely to be
black,
and had more abnormal
lipid proviles.
Results ·
HIV positive patients had
significantly impaired FMD, compared with control subjects
(mean (P < .0001)
·
When adjustments were
made for smoking status, sex, and body mass index, the difference
between the 2 groups remained statistically significant (P
< .01).
·
In a cross-sectional
analysis of the HIV-infected patients, the researchers found significant
associations between FMD and current injection
drug use, hazardous drinking,
HIV
load, and alpha-high-density lipoprotein triglyceride
levels, but not PI therapy.
·
In a multivariate
analysis, only current injection drug use and a lower alpha-high-density
lipoprotein triglyceride level were significantly associated
with FMD.In
conclusion, the authors write, “We conclude that HIV-infected persons
have substantial impairment of endothelial vasomotor function
and that this impairment is worse among persons with elevated
levels of HIV replication, particularly IDUs.”
“In
the present study, impaired endothelial function was not
associated with PI therapy; however, it was associated with
a lower  -HDL
triglyceride level, which is a presumed marker of metabolic
imbalance. Prospective studies are needed to determine whether
effective antiretroviral treatment can lead to improved
endothelial function in HIV-infected persons.” 04/25/06 Reference
A Solages,
J A Vita, D J Thornton and others. Endothelial Function in HIV-Infected Persons. Endothelial Function
in HIV-Infected Persons. Clinical
Infectious Diseases 42(9): 1325-1332. May 1, 2006.
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