Phiri et al., 2018 Effects of Antiretroviral Therapy (Tenofovir/Lamivudine/Efavirenz) on Arterial Stiffness in Black African HIV-1 Infected Men
Background: Cardiovascular diseases are a leading cause of morbidity and mortality worldwide, especially in people living with HIV (PLHIV) as they are said to be more prone. The introduction of combination antiretroviral therapy (cART) has greatly improved the life span of HIV-infected persons. However, its use has been implicated to be a factor in increasing arterial stiffness, a marker of cardiovascular risk. Pulse Wave Velocity (PWV), a surrogate measure of arterial stiffness, is said to be raised in PLHIV on ART.
Aim: This study was conducted to determine the effects of cART (Tenofovir/Lamivudine/Efavirenz) on arterial stiffness in HIV-1 infected men after the first month of treatment.
Methods: A prospective observational study in Lusaka, Zambia was done over a 3 month period from April to June, 2017. A systematic sampling technique with a sampling interval of 5 was used to recruit 26 HIV-1 positive newly diagnosed male cART-naïve participants, between the ages of 20 and 40 years at Adult Infectious Diseases Center (AIDC), University Teaching Hospital (UTH). Two data forms were used to collect data, a short questionnaire and Clinical entry tool for demographical and clinical information respectively. A Complior® Analyse device (Version 1.9 Beta 2013; ALAM-Medical, France) was used by noninvasively accessing superficial pulses over the carotid-femoral (cf) and carotid-radial (cr) segments.
Results: Major findings showed that cART was associated with a significant increase in mean crPWV and crASI from their initial measurements in stage 1 compared to the second measurements in stage 2 (crPWV 10.02±2.06 m/s Vs 11.78±1.23 m/s, p= 0.001) and (crASI 24 ± 4.62 m/s Vs 28±2.8 m/s, p= 0.002) respectively. The measurements for cfPWV and cfASI did not show a significant change statistically even though there was a numerical increase (cfPWV 8.43±1.34 m/s Vs 8.68±1.74 m/s, p= 0.490) and (cfASI 27.37 ± 3.88 m/s Vs 28.59±5.57 m/s, p= 0.295) respectively.
Conclusion: The cART use for a month was associated with a significant increase in PWV and ASI in arteries of HIV-1 infected participants suggesting probable interaction of cART with vascular pathophysiological factors in this population. It is advised that patients on cART be closely monitored for cardiovascular risk factors. This must start early in the treatment period.