title: Endothelial activation and cardiometabolic profiles of treated and never-treated HIV infected Africans.
abstract: OBJECTIVE
  The role the human immunodeficiency virus (HIV) and antiretroviral treatment on endothelial activation, and the subsequent relationship with cardiovascular disease, is not well understood. We investigated endothelial activation, inflammatory and cardiometabolic profiles, and measures of vascular structure and function of 66 antiretroviral treated (ART), 78 never-treated (no-ART) HIV infected and 165 HIV free Africans.
  
  
  METHODS
  Blood samples were obtained for biochemical analysis and blood pressure, pulse wave velocity (PWV) and carotid intima-media thickness (IMT) measurements were performed.
  
  
  RESULTS
  The HIV infection duration was at least five years and the treatment 2.86±0.13 years. The intracellular adhesion molecule (ICAM) and vascular cell adhesion molecule (VCAM) levels were elevated in the HIV infected groups compared to the controls. The odds of higher adhesion molecule levels were increased when HIV infected (especially in the no-ART group); OR no-ART vs. no-HIV: ICAM 3.92 (2.2-7.0); VCAM 16.2 (7.5-35). ICAM and VCAM associated with HIV status and interleukin-6 (IL-6) in the total group (all p<0.01). In both HIV infected groups VCAM associated inversely with CD4 counts (no-ART: β=-0.28, p=0.01; ART: β=-0.22, p=0.07) and TC (no-ART: β=-0.36, p<0.01; ART: β=-0.27, p=0.03). The ART group had an unfavourable lipid profile compared to the no-ART group. The inflammatory markers (C-reactive protein (CRP) and IL-6), PWV and IMT did not differ between the three groups.
  
  
  CONCLUSIONS
  HIV infected Africans showed endothelial activation when compared to HIV free controls. The endothelial activation was not accompanied by increased inflammation (as measured with CRP and IL-6), arterial stiffness or sub-clinical atherosclerosis.
authors: Hypertension in Africa Research Team (HART), North-West University, Potchefstroom 2520, South Africa. Electronic address: carla.fourie@nwu.ac.za.
authors: C M T
authors: CM
authors: Fourie
authors: MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom 2520, South Africa.
authors: A E
authors: AE
authors: Schutte
authors: Hypertension in Africa Research Team (HART), North-West University, Potchefstroom 2520, South Africa.
authors: W
authors: W
authors: Smith
authors: AUTHeR (Africa Unit for Transdisciplinary Health Research), Faculty of Health Science, North-West University, Potchefstroom, South Africa.
authors: A
authors: A
authors: Kruger
authors: Hypertension in Africa Research Team (HART), North-West University, Potchefstroom 2520, South Africa.
authors: J M
authors: JM
authors: van Rooyen
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D044383:Black People; D001794:Blood Pressure; D018791:CD4 Lymphocyte Count; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis / Q000208:ethnology / Q000503:physiopathology*; D002340:Carotid Artery Diseases / Q000097:blood / Q000175:diagnosis / Q000208:ethnology / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004730:Endothelium, Vascular / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000208:ethnology / Q000503:physiopathology*; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D059289:Vascular Stiffness
chemical_list: D019380:Anti-HIV Agents; D015415:Biomarkers; C573420:ICAM1 protein, human; D018836:Inflammation Mediators; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1
keywords: Africans; Cardiometabolic; Endothelial activation; HIV; ICAM; VCAM