title: Evaluation of endothelial function and arterial stiffness in HIV-infected patients: a pilot study.
abstract: BACKGROUND
  In the era of combination antiretroviral therapy (cART), life expectancy of HIV-infected patients is the same as that of the general population, resulting in increasing prevalence of cardiovascular disease in this patient group.
  
  
  OBJECTIVE
  To assess the prevalence of endothelial dysfunction in HIV-infected patients and to identify factors which affect endothelial function and arterial stiffness.
  
  
  METHODS
  Thirty-seven adult HIV-infected patients, regardless of the fact and the type of cART, were enrolled into the study. In patient, reactive hyperaemia peripheral arterial tonometry assessment was performed using the Endo-PAT2000 device (ITAMAR®). This method allows evaluation of endothelial function ant arterial stiffness.
  
  
  RESULTS
  Final analysis included 37 patients (median age 38 years, range 32-45 years), including 89.2% men. Endothelial dysfunction was found in 13 (35.1%) HIV-infected patients. We found no differences in demographic and clinical characteristics, laboratory data, and cardiovascular drug therapy between patients with or without endothelial dysfunction, except for platelet count which was higher in patients with endothelial dysfunction (174 [119-193] × 10³/mm3 vs. 222 [168-266] × 10³/mm³, p = 0.03). No demographic or clinical variables were identified as predictors of endothelial dysfunction in HIV-infected patients. In addition, no association was found between factors related to HIV infection, chronic drug therapy and the risk of endothelial dysfunction. Statistically significant correlations were found between arterial stiffness and age (rs = 0.53, p < 0.001), red blood cell count (rs = -0.39, p = 0.018), and platelet count (rs = 0.42, p = 0.009). CD4+ and CD8+ lymphocyte count and viral load were similar in patients with or without endothelial dysfunction. Arterial stiffness was significantly higher in patients with higher viral load (rs = -0.39, p = 0.0018) and in those with established AIDS (9.5 [1.0-16.0] vs. -5 [-10-5], p = 0.009). cART had no effect on endothelial dysfunction, while arterial stiffness was higher in patients treated with cART (10 [0-15] vs. -5 [-10-3], p = 0.014).
  
  
  CONCLUSIONS
  Endothelial dysfunction is common in HIV-infected patients. In general, none of the analysed factors had an effect on endothelial function but cART had a negative effect on arterial stiffness.
authors.forename: Paweł
authors.initials: P
authors.lastname: Balsam
authors.forename: Tomasz
authors.initials: T
authors.lastname: Mikuła
authors.affiliation: I Katedra i Klinika Kardiologii Warszawski Uniwersytet Medyczny. michalpeller@gmail.com.
authors.forename: Michał
authors.initials: M
authors.lastname: Peller
authors.forename: Magdalena
authors.initials: M
authors.lastname: Suchacz
authors.forename: Bartosz
authors.initials: B
authors.lastname: Puchalski
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Kołtowski
authors.forename: Renata
authors.initials: R
authors.lastname: Główczyńska
authors.forename: Alicja
authors.initials: A
authors.lastname: Wiercińska-Drapalo
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Opolski
authors.forename: Krzysztof J
authors.initials: KJ
authors.lastname: Filipiak
mesh_terms: D000328:Adult; D004730:Endothelium, Vascular / Q000503:physiopathology* / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D059289:Vascular Stiffness; D019562:Viral Load