title: Impact of HIV infection and antiretroviral treatment on N-terminal prohormone of brain natriuretic peptide as surrogate of myocardial function.
abstract: Vasoactive cardiovascular hormones such as the N-terminal prohormone of brain natriuretic peptide (NT-proBNP) are produced upon ventricular stretch and play a central role in neurohumoral pathways of the heart regulating cardiovascular remodeling and volume homeostasis. The impact of HIV infection on these neurohumoral pathways of the heart and its potential reversibility by combinations of antiretroviral therapies remain unclear.
  
  
  
  We assessed serum levels of NT-proBNP in 219 antiretroviral therapy-naïve HIV-infected patients with a normal cardiac and renal status at treatment initiation and after attainment of viremic control.
  
  
  
  Before antiretroviral therapy, NT-proBNP as a surrogate of myocardial function displayed a significant correlation with absolute CD4 cell count (r = -0.31; P < 0.001) as well as with HIV viral load (r = 0.26; P < 0.001). The median levels of NT-proBNP were 80 pg/ml (36-205) in patients with a CD4 cell count less than 200 cells/μl and 42 pg/ml (20-80; P < 0.001) with a CD4 cell count more than 500 cells/μl. After viremic control, no statistical correlation was present.
  
  
  
  Higher NT-proBNP levels were observed in treatment-naïve patients with low CD4 cell count and high HIV viral load, indicating a subclinical impact of HIV infection on myocardial function. This association is reversible by the initiation of antiretroviral therapy and subsequent viral suppression.
authors.affiliation: aDivision of Immunology, Allergy and Infectious Diseases, Department of DermatologybDepartment of Internal Medicine IIcDivision of Clinical Virology, Department of Laboratory MedicinedDivision of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Christopher
authors.initials: C
authors.lastname: Schuster
authors.forename: Christina
authors.initials: C
authors.lastname: Binder
authors.forename: Robert
authors.initials: R
authors.lastname: Strassl
authors.forename: Maximilian C
authors.initials: MC
authors.lastname: Aichelburg
authors.forename: Emma
authors.initials: E
authors.lastname: Blackwell
authors.forename: Noemi
authors.initials: N
authors.lastname: Pavo
authors.forename: Michael
authors.initials: M
authors.lastname: Ramharter
authors.forename: Martin
authors.initials: M
authors.lastname: Hülsmann
authors.forename: Katharina
authors.initials: K
authors.lastname: Grabmeier-Pfistershammer
authors.forename: Armin
authors.initials: A
authors.lastname: Rieger
authors.forename: Georg
authors.initials: G
authors.lastname: Goliasch
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood*; D018791:CD4 Lymphocyte Count; D009202:Cardiomyopathies / Q000175:diagnosis*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D019562:Viral Load
chemical_list: D044966:Anti-Retroviral Agents; D015415:Biomarkers; D010446:Peptide Fragments; D020097:Natriuretic Peptide, Brain