Endothelial function in HIV-infected persons.
BACKGROUND
Several reports have suggested an increased risk of coronary disease in human immunodeficiency virus (HIV)-infected patients receiving protease inhibitors (PIs). Impaired endothelium-dependent vasodilation is a putative surrogate marker of coronary atherosclerotic disease.


METHODS
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.


RESULTS
HIV-infected patients had significantly impaired FMD, compared with control subjects (mean +/- SD, 7.3% +/- 4.4% vs. 11.1% +/- 6.3%; 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, we 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.


CONCLUSIONS
HIV-infected patients have significant impairment of endothelial function, and this impairment is worse among those with elevated levels of HIV replication, particularly injection drug users.
Division of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
Anthony
A
Solages
Joseph A
JA
Vita
David J
DJ
Thornton
Jessica
J
Murray
Timothy
T
Heeren
Donald E
DE
Craven
C Robert
CR
Horsburgh
D000328:Adult; D003324:Coronary Artery Disease / Q000209:etiology*; D004730:Endothelium, Vascular / Q000502:physiology*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014664:Vasodilation / Q000502:physiology*