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

Giovanni Mulè; Giuseppe Mulè; Valeria Tranchida; Pietro Colletti; Giovanni Mazzola; Marcello Trizzino; Claudia Colomba; Antonio Cascio

doi:10.2991/artres.k.200314.002

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Volume 26, Issue 1, March 2020, Pages 13 - 20

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

Authors

Giovanni Mulè¹^{, †}, Giuseppe Mulè²^{, *}^{, †}, Valeria Tranchida², Pietro Colletti¹, Giovanni Mazzola¹, Marcello Trizzino¹, Claudia Colomba¹, Antonio Cascio¹

¹Department 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

²European 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

^†

These two authors contributed equally to this work.

^*Corresponding author. Email: giuseppe.mule@unipa.it

Corresponding Author

Giuseppe Mulè

Received 12 March 2020, Accepted 14 March 2020, Available Online 19 March 2020.

DOI: 10.2991/artres.k.200314.002 How to use a DOI?
Keywords: HIV infection; cardiovascular risk; pulse wave velocity; aortic stiffness
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.
Open Access: This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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Journal: Artery Research
Volume-Issue: 26 - 1
Pages: 13 - 20
Publication Date: 2020/03/19
ISSN (Online): 1876-4401
ISSN (Print): 1872-9312
DOI: 10.2991/artres.k.200314.002 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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ris enw bib

TY  - JOUR
AU  - Giovanni Mulè
AU  - Giuseppe Mulè
AU  - Valeria Tranchida
AU  - Pietro Colletti
AU  - Giovanni Mazzola
AU  - Marcello Trizzino
AU  - Claudia Colomba
AU  - Antonio Cascio
PY  - 2020
DA  - 2020/03/19
TI  - Aortic Stiffness in HIV Infection with and without Antiretroviral Therapy. A Meta-analysis of Observational Studies
JO  - Artery Research
SP  - 13
EP  - 20
VL  - 26
IS  - 1
SN  - 1876-4401
UR  - https://doi.org/10.2991/artres.k.200314.002
DO  - 10.2991/artres.k.200314.002
ID  - Mulè2020
ER  -

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