Retinal Arterioles Narrow with Increasing Duration of Anti-Retroviral Therapy in HIV Infection: A Novel Estimator of Vascular Risk in HIV?
Year: 2012
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: HIV infection is associated with an increased risk of age-related morbidity mediated by immune dysfunction, atherosclerosis and inflammation. Changes in retinal vessel calibre may reflect cumulative structural damage arising from these mechanisms. The relationship of retinal vessel calibre with clinical and demographic characteristics was investigated in a population of HIV-infected individuals in South Africa. METHODS: Case-control study of 491 adults ≥30 years, composed of 242 HIV-infected adults and 249 age- and gender-matched HIV-negative controls. Retinal vessel calibre was measured using computer-assisted techniques to determine mean arteriolar and venular diameters of each eye. RESULTS: The median age was 40 years (IQR: 35-48 years). Among HIV-infected adults, 87.1% were receiving highly active antiretroviral therapy (HAART) (median duration, 58 months), their median CD4 count was 468 cells/µL, and 84.3% had undetectable plasma viral load. Unadjusted mean retinal arteriolar diameters were 163.67±17.69 µm in cases and 161.34±17.38 µm in controls (p = 0.15). Unadjusted mean venular diameters were 267.77±18.21 µm in cases and 270.81±18.98 µm in controls (p = 0.07). Age modified the effect of retinal arteriolar and venular diameters in relation to HIV status, with a tendency towards narrower retinal diameters in HIV cases but not in controls. Among cases, retinal arteriolar diameters narrowed with increasing duration of HAART, independently of age (167.83 µm <3 years of HAART vs. 158.89 µm >6 years, p-trend = 0.02), and with a HIV viral load >10,000 copies/mL while on HAART (p = 0.05). HIV-related venular changes were not detected. CONCLUSIONS: Narrowing of retinal arteriolar diameters is associated with HAART duration and viral load, and may reflect heightened inflammatory and pro-atherogenic states of the systemic vasculature. Measurement of retinal vascular calibre could be an innovative non-invasive method of estimating vascular risk in HIV-infected individuals.
Source: PLoS ONE
Institutions: University of Cape Town, London School of Hygiene & Tropical Medicine, Institute of Infectious Disease and Molecular Medicine, International Centre for Eye Health, Moorfields Eye Hospital NHS Foundation Trust, NIHR Moorfields Biomedical Research Centre, University College London, Groote Schuur Hospital, National University of Singapore, Singapore Eye Research Institute
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,382
Awards: Wellcome Trust Clinical PhD Programme in International Health at the LSHTM: 'Immune recovery uveitis in HIV-infected adults in India: incidence and risk factors'., Wellcome Trust Clinical PhD Programme in International Health at the LSHTM: 'Immune recovery uveitis in HIV-infected adults in India: incidence and risk factors'., Intensified tuberculosis case finding and rapid detection of drug resistant disease in patients accessing antiretroviral treatment in South Africa.
OpenAlex ID: W2117401869