Arterial stiffness in HIV-infected youth and associations with HIV-related variables.
Children and young adults infected with HIV are at elevated risk for cardiovascular disease (CVD). However, scarce data exist on the utility of non-invasive methods to diagnose subclinical CVD, such as pulse wave velocity (PWV), a non-invasive measure of arterial stiffness. The objectives of this study were to assess the relationship of carotid-femoral PWV with subclinical atherosclerosis measured by carotid intima-media thickness (IMT), compare measurements to healthy controls, and evaluate variables associated with PWV in HIV-infected youth. One hundred and one 8-25 year-old subjects on stable antiretroviral therapy with low-level viremia or an undetectable HIV-1 RNA were enrolled, along with 86 healthy controls similar in age, sex and race. There was no significant difference in PWV between groups (median (Q1, Q3): 5.7 (5.2, 6.3) vs 5.7 (4.9, 6.5) m/s; P = 0.81). Among the HIV-infected subjects, PWV was positively correlated with both internal carotid artery (R = 0.31, P = 0.02) and carotid bulb IMT (R = 0.29, P = 0.01). In multivariable regression, only current alcohol consumption and systolic blood pressure were independently associated with PWV in the HIV-infected group (where current alcohol consumption and higher systolic blood pressure were associated with higher PWV); whereas, age, body mass index, and current marijuana use were associated with PWV in healthy controls. In this study of PWV in HIV-infected youth, measures of arterial stiffness were not different between subjects and controls. However, in HIV-infected youth, there was a significant association between PWV and carotid IMT, as well as between PWV and current alcohol consumption. Thus, PWV may have potential as a useful, non-invasive method to assess CVD risk in HIV-infected youth, but further investigation is needed.
a Medical University of South Carolina , Charleston , SC , USA.|b Emory University School of Medicine , Atlanta , GA , USA.
Allison Ross
AR
Eckard
b Emory University School of Medicine , Atlanta , GA , USA.|c Mazankowski Alberta Heart Institute and University of Alberta , Edmonton , Alberta , Canada.
Paolo
P
Raggi
d Rush University , Chicago , IL , USA.
Joshua H
JH
Ruff
e Rainbow Babies and Children's Hospital/University Hospitals Case Medical Center , Cleveland , OH , USA.
Mary Ann
MA
O'Riordan
b Emory University School of Medicine , Atlanta , GA , USA.
Julia C
JC
Rosebush
e Rainbow Babies and Children's Hospital/University Hospitals Case Medical Center , Cleveland , OH , USA.
Danielle
D
Labbato
b Emory University School of Medicine , Atlanta , GA , USA.
Julie E
JE
Daniels
b Emory University School of Medicine , Atlanta , GA , USA.
Monika
M
Uribe-Leitz
e Rainbow Babies and Children's Hospital/University Hospitals Case Medical Center , Cleveland , OH , USA.
Christopher T
CT
Longenecker
e Rainbow Babies and Children's Hospital/University Hospitals Case Medical Center , Cleveland , OH , USA.
Grace A
GA
McComsey
D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D015497:HIV-1 / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008297:Male; D063177:Pulse Wave Analysis; D059289:Vascular Stiffness; D055815:Young Adult
D019380:Anti-HIV Agents
HIV; alcohol use; antiretroviral therapy; arterial stiffness; cardiovascular disease; carotid intima-media thickness; pediatrics and adolescents; pulse wave velocity