Effect of antiretroviral therapy on decreasing arterial stiffness, metabolic profile, vascular and systemic inflammatory cytokines in treatment-naïve HIV: A one-year prospective study

PLoS One. 2023 Mar 17;18(3):e0282728. doi: 10.1371/journal.pone.0282728. eCollection 2023.

Abstract

Introduction: Cardiovascular disease is a major cause of death among people living with HIV (PLH). Non-treated PLH show increased levels of inflammation and biomarkers of vascular activation, and arterial stiffness as a prognostic cardiovascular disease risk factor. We investigated the effect of one year of ART on treatment-naïve HIV(+) individuals on arterial stiffness and inflammatory and vascular cytokines.

Methods: We cross-sectionally compared aortic stiffness via tonometry, inflammatory, and vascular serum cytokines on treatment-naïve (n = 20) and HIV (-) (n = 9) matched by age, sex, metabolic profile, and Framingham score. We subsequently followed young, treatment-naïve individuals after 1-year of ART and compared aortic stiffness, metabolic profile, and inflammatory and vascular serum biomarkers to baseline. Inflammatory biomarkers included: hs-CRP, D-Dimer, SAA, sCD163s, MCP-1, IL-8, IL-18, MRP8/14. Vascular cytokines included: myoglobin, NGAL, MPO, Cystatin C, ICAM-1, VCAM-1, and MMP9.

Results: Treatment-naïve individuals were 34.8 years old, mostly males (95%), and with high smoking prevalence (70%). Baseline T CD4+ was 512±324 cells/mcL. cfPWV was similar between HIV(-) and treatment-naïve (6.8 vs 7.3 m/s; p = 0.16) but significantly decreased after ART (-0.52 m/s; 95% CI -0.87 to -0.16; p0.006). Almost all the determined cytokines were significantly higher compared to controls, except for MCP-1, myoglobin, NGAL, cystatin C, and MMP-9. At follow-up, only total cholesterol and triglycerides increased and all inflammatory cytokines significantly decreased. Regarding vascular cytokines, MPO, ICAM-1, and VCAM-1 showed a reduction. D-Dimer tended to decrease (p = 0.06) and hs-CRP did not show a significant reduction (p = 0.17).

Conclusion: One year of ART had a positive effect on reducing inflammatory and vascular cytokines and arterial stiffness.

MeSH terms

  • Adult
  • Biomarkers
  • C-Reactive Protein / metabolism
  • Cardiovascular Diseases*
  • Cystatin C / metabolism
  • Cytokines / metabolism
  • Female
  • HIV Infections* / drug therapy
  • Humans
  • Intercellular Adhesion Molecule-1 / metabolism
  • Lipocalin-2 / metabolism
  • Male
  • Metabolome
  • Myoglobin / metabolism
  • Prospective Studies
  • Vascular Cell Adhesion Molecule-1
  • Vascular Stiffness*

Substances

  • C-Reactive Protein
  • Intercellular Adhesion Molecule-1
  • Cystatin C
  • Cytokines
  • Vascular Cell Adhesion Molecule-1
  • Lipocalin-2
  • Myoglobin
  • Biomarkers

Grants and funding

The author(s) received no specific funding for this work.