Central arterial stiffness in young adults with perinatal HIV exposure and infection.

Abstract

Objective: The aim of this study was to compare arterial stiffness between young adults with perinatally acquired HIV (YAPHIV) and young adults' perinatally HIV exposed but uninfected (YAPHEU).

Design: A cross-sectional analysis of pulse wave velocity (PWV) measures among participants with echocardiography in the PHACS Cardiac Toxicity Substudy.

Methods: A total of 150 participants (95 YAPHIV, 55 YAPHEU, mean 23.4 years, 60% female, 72% Black, 24% Hispanic) had echocardiography and PWV measured. We compared PWV between groups. Among YAPHIV, we fit linear regression models to evaluate the association of measures of HIV disease severity and antiretroviral treatment (ART) with PWV. We computed correlations between PWV and measures of left ventricular structure and function.

Results: Mean PWV did not differ by group (YAPHIV 5.63 vs. YAPHEU 5.39 m/s; P  = 0.50). HIV control was good (82% with viral load <400 copies/ml); 91% used combination ART. Mean PWV was normal, but three of 95 YAPHIV (3%) had values above 11.8 m/s (level associated with cardiovascular events in adults). Weak correlations (<0.20) were observed between PWV and echocardiographic measures. Among YAPHIV, current and historical HIV severity measures were not associated with PWV. YAPHIV on protease inhibitor based ART had higher mean PWV than those on integrase strand inhibitors (1.68 m/s higher, 95% confidence interval -0.36, 3.72) or nonnucleoside transcriptase inhibitors (1.58 m/s higher, 95% confidence interval -0.94, 4.11).

Conclusion: Our data show no difference in PWV between those perinatally exposed to and perinatally infected with HIV. Therefore, cardiovascular risk reduction guidelines should be followed to prevent cardiovascular disease in all young adults.