Central arterial stiffness in young adults with perinatal HIV exposure & infection.

Objective: To compare arterial stiffness between young adults with perinatally acquired HIV (YAPHIV) and young adults perinatally HIV exposed but uninfected (YAPHEU).

Design: Cross-sectional analysis of pulse wave velocity (PWV) measures among participants with echocardiography in the PHACS Cardiac Toxicity Substudy.

Methods: A total of 150 participants (95 YAPHIV, 55 YAPHEU, mean 23.4 years, 60% female, 72% Black, 24% Hispanic) had echocardiography and PWV measured. We compared PWV between groups. Among YAPHIV, we fit linear regression models to evaluate the association of measures of HIV disease severity and antiretroviral treatment (ART) with PWV. We computed correlations between PWV and measures of left ventricular structure and function.

Results: Mean PWV did not differ by group (YAPHIV 5.63 vs YAPHEU 5.39 m/s; P = 0.50). HIV control was good (82% with viral load <400 copies/ml); 91% used combination ART. Mean PWV was normal, but 3 of 95 YAPHIV (3%) had values above 11.8 m/s (level associated with cardiovascular events in adults). Weak correlations (<0.20) were observed between PWV and echocardiographic measures. Among YAPHIV, current and historical HIV severity measures were not associated with PWV. YAPHIV on protease inhibitor (PI)-based ART had higher mean PWV than those on integrase strand inhibitors (1.68 m/s higher, 95% CI -0.36, 3.72) or nonnucleoside transcriptase inhibitors (1.58 m/s higher, 95% CI -0.94, 4.11).

Conclusions: Our data shows no difference in PWV between those perinatally exposed to and perinatally infected with HIV. Therefore, CV risk reduction guidelines should be followed to prevent CV disease in all young adults.