title: Aortic stiffness aging is influenced by past profound immunodeficiency in HIV-infected individuals: results from the EVAS-HIV (EValuation of Aortic Stiffness in HIV-infected individuals).
abstract: We compared aortic stiffness between HIV-infected and HIV-uninfected individuals and examined the determinants of vascular aging during HIV infection.
  
  
  
  Aortic stiffness using carotid-femoral pulse wave velocity (cf-PWV) was evaluated cross-sectionally between HIV-infected individuals and uninfected controls frequency-matched for age and sex, and longitudinally in a subgroup of HIV-infected individuals. Determinants of elevated cf-PWV levels were assessed using logistic regression. Changes in cf-PWV levels during follow-up (mixed-effect linear regression) and risk factors for achieving cf-PWV below (Group 1) or above the median (Group 2) at last follow-up visit were evaluated only in HIV-infected individuals.
  
  
  
  A total of 133 HIV-infected and 135 HIV-uninfected individuals (mean age: 47.7 ± 8.9 years, 91% men) were enrolled. Median cf-PWV at baseline was similar between HIV-infected individuals and controls [7.5 m/s (interquartile range = 6.7-8.4) vs. 7.5 m/s (interquartile range = 6.6-8.4), respectively; P = 0.64]. In multivariable analysis, only mean arterial pressure showed significant association with elevated cf-PWV in the overall population (P = 0.036). In HIV-infected individuals, elevated cf-PWV was associated with current smoking (P = 0.042), and nadir CD4 T-cell count less than 200 cells/μl (P = 0.048). Ninety-one HIV-infected individuals were followed for a mean 7.6 ± 2.0 years. cf-PWV progression was associated with age (P = 0.018), mean arterial pressure (P = 0.020), and nadir CD4 T-cell count (P = 0.005). Patients from Group 2 had higher baseline waist circumference, pulse pressure, and nadir CD4 T-cell count less than 200 cells/μl.
  
  
  
  We observed no difference in aortic stiffness between HIV-infected and controls. Moreover, aortic stiffness aging was independently associated with past severe immunodeficiency, along with other traditional risk factors. Our results call for early antiretroviral initiation.
authors.affiliation: aDepartment of Infectious Diseases, São Francisco de Assis Hospital, Federal University, Rio de Janeiro, Brazil bAP-HP, Hôpital Saint-Antoine, Service de cardiologie, Paris, France cDepartment of Cardiology, Brugmann Hospital, Universite Libre de Bruxelles, Brussels, Belgium dSorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136) eUniversité Paris Descartes, Sorbonne Paris Cité, APHP-Hôpital Necker-Enfants malades, Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur fIHU Imagine gUniversité Paris Descartes, Sorbonne Paris Cité, Paris, France hDepartment of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA iINSERM Epidemiology and Biostatistics Research Center, Sorbonne Paris Cité, INSERM UMR 1153 jMaladies Infectieuses et Tropicales, Hôpital Pitié Salpêtrière, AP-HP kService de Maladies Infectieuses et Tropicales, Hôpitaux Universitaires de l'Est Parisien, Hôpital Saint-Antoine lSorbonne Universités, UPMC Univ Paris 06 mINSERM, UMR_S 938, UPMC, Paris, France.
authors.forename: Luísa H
authors.initials: LH
authors.lastname: Maia-Leite
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Catez
authors.forename: Anders
authors.initials: A
authors.lastname: Boyd
authors.forename: Nabila
authors.initials: N
authors.lastname: Haddour
authors.forename: Angelique
authors.initials: A
authors.lastname: Curjol
authors.forename: Sylvie
authors.initials: S
authors.lastname: Lang
authors.forename: Mabel
authors.initials: M
authors.lastname: Nuernberg
authors.forename: Claudine
authors.initials: C
authors.lastname: Duvivier
authors.forename: Moise
authors.initials: M
authors.lastname: Desvarieux
authors.forename: Miriam
authors.initials: M
authors.lastname: Kirstetter
authors.forename: Pierre-Marie
authors.initials: PM
authors.lastname: Girard
authors.forename: Ariel
authors.initials: A
authors.lastname: Cohen
authors.forename: Franck
authors.initials: F
authors.lastname: Boccara
mesh_terms: D000328:Adult; D000375:Aging / Q000502:physiology*; D001011:Aorta / Q000503:physiopathology*; D062186:Arterial Pressure; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000276:immunology / Q000503:physiopathology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D012307:Risk Factors; D012907:Smoking; D059289:Vascular Stiffness