title: Cross-sectional study of endothelial function in HIV-infected patients in Brazil.
abstract: Antiretroviral therapy (ART) in HIV-infected patients has been associated with an increased risk of cardiovascular disease. This study evaluates vascular endothelial dysfunction of the peripheral circulation in Brazilian HIV-infected subjects on ART or naive to ART compared to a control group matched for age and body mass index (BMI). We performed a cross-sectional comparative study to measure postischemic peak flow-mediated dilation (FMD) of the brachial artery and the response to glyceryl trinitrate (GTN) in HIV-infected patients and healthy controls in Salvador, Bahia, Brazil. Endothelial vasomotor function was evaluated by assessing brachial artery FMD. Forty-four HIV-infected individuals (33 ARV treated and 11 ART naive) were compared to 25 healthy controls matched for age and BMI. FMD % was significantly lower for the ART-experienced patients compared to the ART-naive patients and was also significantly different from controls (ART experienced 8.2 +/- 6.0% vs. 19.3 +/- 4.8% vs. 23.3 +/- 6.1%), respectively (p < 0.0001). The cholesterol, triglyceride, and ALT levels were significantly higher in the ART-experienced group compared to the ART-naive and control subjects (p < 0.028); however, linear regression analysis revealed a statistically significant association of endothelial dysfunction as a dependent variable only with ARV treatment in HIV-infected subjects (p = 0.03). The association of endothelial dysfunction with ARV therapy in HIV-infected patients was independent of protease inhibitor-containing regimens or dyslipidemia. This dysfunction may contribute to the risk for HIV-associated atherosclerosis.
authors.affiliation: Bahian School of Medicine and Public Health, Bahia, Brazil. anaandrade@terra.com.br
authors.forename: Ana Cristina O
authors.initials: AC
authors.lastname: Andrade
authors.forename: Ana Marice
authors.initials: AM
authors.lastname: Ladeia
authors.forename: Eduardo M
authors.initials: EM
authors.lastname: Netto
authors.forename: Amanda
authors.initials: A
authors.lastname: Mascarenhas
authors.forename: Bruno
authors.initials: B
authors.lastname: Cotter
authors.forename: Constance A
authors.initials: CA
authors.lastname: Benson
authors.forename: Roberto
authors.initials: R
authors.lastname: Badaró
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D015992:Body Mass Index; D001916:Brachial Artery / Q000187:drug effects / Q000502:physiology; D001938:Brazil; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000150:complications / Q000503:physiopathology; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000821:virology; D017320:HIV Protease Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D014664:Vasodilation / Q000187:drug effects
chemical_list: D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors; D005996:Nitroglycerin