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Aortic Stiffness in HIV Infection with and without Antiretroviral Therapy. A Meta-analysis of Observational Studies

Artery Research volume 26, pages 13–20 (2020)Cite this article

Abstract

Background

The risk of Cardiovascular (CV) events is higher in HIV-infected patients (HIV+) compared to HIV-uninfected persons (HIV−). Large artery stiffness, a well-documented predictor of adverse CV prognosis, may mediate this enhanced risk. It is usually assessed by measuring aortic Pulse Wave Velocity (aPWV). Studies examining arterial stiffness in HIV+ yielded inconsistent results. We performed a meta-analysis with the aim to evaluate the association of HIV infection and its therapy [Antiretroviral Therapy (ART)] with aPWV.

Design and Method

The Standardized Mean Difference (SMD) and corresponding 95% confidence intervals were calculated for aPWV in different comparison groups. Statistical heterogeneity, assessed by Q-test and I2` statistic, was observed in all these comparisons. Therefore, random effects model was implemented.

Results

In a total of 12 studies, naive HIV+ (n = 547) showed increased aPWV compared to HIV− (n = 864): SMD = 0.333 (0.125–0.542), p < 0.002. A total of 22 studies were identified comparing HIV+ treated with ART (n = 3348) to HIV− (n = 2547) showing higher values of aPWV in the former than in latter: SMD = 0.391 (0.225–0.556), p < 0.001. In 10 studies, HIV+ treated with ART (n = 761) exhibited greater aPWV values than those of naive HIV+ (n = 457): SMD = 0.262 (0.006–0.518), p = 0.045.

Conclusion

Our meta-analysis seems to suggest that HIV infection “per se” and ART may impair aortic distensibility. However, interpretation of our results needs caution due to between-study heterogeneity and some potential publication biases.

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Author notes

  1. These two authors contributed equally to this work.

Authors and Affiliations

  1. Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Unit of Infectious Diseases, University of Palermo, via del Vespro, 129, Palermo, 90127, Italy

    Giovanni Mulè, Pietro Colletti, Giovanni Mazzola, Marcello Trizzino, Claudia Colomba & Antonio Cascio

  2. European Society of Hypertension Excellence Centre, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Unit of Nephrology and Hypertension, University of Palermo, via del Vespro, 129, Palermo, 90127, Italy

    Giuseppe Mulè & Valeria Tranchida

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  1. Giovanni Mulè
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Correspondence to Giuseppe Mulè.

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Peer review under responsibility of the Association for Research into Arterial Structure and Physiology

Data availability statement: The data that support the findings of this study are available on request from the corresponding author, GM.

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Mulè, G., Mulè, G., Tranchida, V. et al. Aortic Stiffness in HIV Infection with and without Antiretroviral Therapy. A Meta-analysis of Observational Studies. Artery Res 26, 13–20 (2020). https://doi.org/10.2991/artres.k.200314.002

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  • DOI: https://doi.org/10.2991/artres.k.200314.002

Keywords

Artery Research

ISSN: 1876-4401

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