Initiating antiretroviral therapy (ART) after a diagnosis of human immunodeficiency virus (HIV) infection does not limit the progression of significant arterial inflammation in untreated patients, according to research published in JAMA Cardiology.
Markella V. Zanni, MD, Massachusetts General Hospital and Harvard Medical School, and colleagues, conducted a study of 12 previously untreated HIV-infected patients who underwent screening for arterial inflammation, subclinical atherosclerosis, and systemic immune and metabolic phenotyping before, and at 6 months after, the initiation of ART.
The 12 HIV-positive patients were matched with 12 control participants. None of the participants had a prior history of coronary artery disease, autoimmune or inflammatory disease other than HIV infection, or significant cardiovascular risk factors.
At 6-month follow-up, the researchers conducted positron emission tomography scans and computed tomography angiograms of participants. Dr Zanni and colleagues found that 80% of HIV-positive participants had developed increased inflammation of the aorta during the 6-month study period.
“Previous studies have found that persistent arterial inflammation may predispose people living with HIV to the development of high-risk coronary artery plaques that are potentially more likely to rupture and cause a heart attack,” said Dr Zanni. “Our findings suggest that additional strategies geared toward reducing arterial inflammation among HIV-infected patients receiving ART may be needed.”
- Zanni MV, Toribio M, Robbins GK, et al. Effects of antiretroviral therapy on immune function and arterial inflammation in treatment-naïve patients with human immunodeficiency virus infection. JAMA Cardiol. 2016; doi: 10.1001/jamacardio.2016.0846 [Epub ahead of print]