title: Is HIV-1 infection associated with endothelial dysfunction in a population of African ancestry in South Africa?
abstract: The chronic infection status suffered by HIV-infected individuals promotes chronic arterial inflammation and injury, which leads to dysfunction of the endothelium, atherosclerosis and thrombosis. Although HIV-1 subtype C is prevalent in South Africa and accounts for almost a third of the infections worldwide, this subtype differs genetically from HIV-1 subtype B on which the majority of studies have been done. The objective of this study was to assess whether newly identified, never-treated, HIV-1-infected South African participants showed signs of endothelial dysfunction, accelerated atherosclerosis and increased blood coagulation. We compared 300 newly diagnosed (never antiretroviraltreated) HIV-infected participants to 300 age-, gender-, body mass index- and locality-matched uninfected controls. Levels of high-density lipoprotein cholesterol (HDL-C), triglycerides, interleukin-6 (IL-6), C-reactive protein (CRP), intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), fibrinogen and plasminogen activator inhibitor-1 (PAI-1), and carotid radialis pulse wave velocity (cr-PWV) were determined. The HIV-infected participants showed lower HDL-C and higher IL-6, CRP, ICAM-1 and VCAM-1 levels compared to the uninfected controls. No differences in fibrinogen and PAI-1 levels were detected. A continuous positive trend of increasing age with cr-PWV was detected in the HIV-infected group. Our findings suggest inflammatory injury of the endothelium, pointing to endothelial dysfunction of never-treated HIV-1-infected South Africans of African ancestry. Although no indication of a prothrombotic state could be detected, there was an indication of accelerated vascular aging and probable early atherosclerosis in the older HIV-infected participants.
authors.affiliation: HART (Hypertension in Africa Research Team), Physiology, North-West University, Potchefstroom, South Africa. carla.fourie@nwu.ac.za
authors.forename: C
authors.initials: C
authors.lastname: Fourie
authors.forename: J
authors.initials: J
authors.lastname: van Rooyen
authors.forename: M
authors.initials: M
authors.lastname: Pieters
authors.forename: K
authors.initials: K
authors.lastname: Conradie
authors.forename: T
authors.initials: T
authors.lastname: Hoekstra
authors.forename: A
authors.initials: A
authors.lastname: Schutte
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000208:ethnology / Q000821:virology; D044383:Black People; D001777:Blood Coagulation; D016022:Case-Control Studies; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000208:ethnology* / Q000503:physiopathology*; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D013019:South Africa