Arterial stiffness in HIV-infected youth and associations with HIV-related variables

Abstract

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.

Keywords: HIV; alcohol use; antiretroviral therapy; arterial stiffness; cardiovascular disease; carotid intima-media thickness; pediatrics and adolescents; pulse wave velocity.

Figure 1.

Correlations between PWV and carotid IMT. Scatter plots depict the bivariate relationship between PWV and (A) ICA IMT, (B) carotid bulb IMT, and (C) CCA IMT in the HIV-infected subjects and (D) ICA IMT, (E) carotid bulb IMT, and (F) CCA IMT in the healthy control group. R = Spearman correlation coefficient. PWV, pulse wave velocity; ICA, internal carotid artery; CCA, common carotid artery; IMT, intima-media thickness.