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

Giuseppe Mule', Claudia Colomba, Antonio Cascio, Marcello Trizzino, Valeria Tranchida

Risultato della ricerca: Article

Abstract

Background: The risk of Cardiovascular (CV) events is higher in HIV-infected patients (HIV+) compared to HIV-uninfectedpersons (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+ yieldedinconsistent 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 calculatedfor aPWV in different comparison groups. Statistical heterogeneity, assessed by Q-test and I2 statistic, was observed in all thesecomparisons. 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+ treatedwith 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
Lingua originaleEnglish
pagine (da-a)13-20
Numero di pagine8
RivistaArtery Research
Volume26
Stato di pubblicazionePublished - 2020

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