Retinal arterioles narrow with increasing duration of anti-retroviral therapy in HIV infection: a novel estimator of vascular risk in HIV?

Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

Original Publication: San Francisco, CA : Public Library of Science

Anti-HIV Agents/*therapeutic use ; Arterioles/*drug effects ; HIV Infections/*drug therapy ; Retinal Vessels/*drug effects; Adult ; Anti-HIV Agents/pharmacology ; Antiretroviral Therapy, Highly Active ; Arterioles/pathology ; Case-Control Studies ; Female ; HIV Infections/pathology ; Humans ; Male ; Middle Aged ; Retinal Vessels/pathology

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.

Arch Ophthalmol. 2006 Jan;124(1):87-94. (PMID: 16401789)
Am J Ophthalmol. 2004 Jun;137(6):1050-5. (PMID: 15183789)
Hypertension. 2006 Feb;47(2):189-94. (PMID: 16380526)
AIDS. 2009 Sep 10;23(14):1841-9. (PMID: 19455012)
Am J Ophthalmol. 1974 Apr;77(4):472-7. (PMID: 4819451)
Ophthalmology. 1999 Dec;106(12):2269-80. (PMID: 10599656)
Hypertension. 2006 Aug;48(2):e10; author reply e11. (PMID: 16801487)
Clin Infect Dis. 2009 Oct 1;49(7):1119-27. (PMID: 19712036)
Curr Opin Infect Dis. 2012 Feb;25(1):1-3. (PMID: 22183112)
Ann Intern Med. 2007 Jan 16;146(2):87-95. (PMID: 17227932)
AIDS. 2006 Aug 1;20(12):1605-12. (PMID: 16868441)
Ann Intern Med. 2010 Oct 5;153(7):477-9. (PMID: 20921548)
JAMA. 2001 Jul 11;286(2):180-7. (PMID: 11448281)
Arch Intern Med. 2006 Nov 27;166(21):2388-94. (PMID: 17130394)
Invest Ophthalmol Vis Sci. 2004 Jul;45(7):2129-34. (PMID: 15223786)
Stroke. 2010 Jul;41(7):1343-8. (PMID: 20508189)
J Infect Dis. 2012 Jun;205 Suppl 3:S362-7. (PMID: 22577209)
Surv Ophthalmol. 2009 Jan-Feb;54(1):74-95. (PMID: 19171211)
N Engl J Med. 2012 Apr 5;366(14):1270-3. (PMID: 22475591)
Br J Ophthalmol. 2004 Jan;88(1):57-61. (PMID: 14693774)
Am J Ophthalmol. 1974 Apr;77(4):478-83. (PMID: 4819452)
Invest Ophthalmol Vis Sci. 2003 Nov;44(11):4644-50. (PMID: 14578380)
Clin Infect Dis. 2011 Dec;53(11):1140-2. (PMID: 21998283)
J Acquir Immune Defic Syndr. 2012 Jul 1;60 Suppl 1:S1-18. (PMID: 22688010)
Ophthalmology. 2004 Jun;111(6):1183-90. (PMID: 15177969)
Ophthalmology. 2005 Apr;112(4):553-8. (PMID: 15808243)
Invest Ophthalmol Vis Sci. 2003 Jul;44(7):2900-4. (PMID: 12824229)
Clin Infect Dis. 2011 Dec;53(11):1127-9. (PMID: 21998279)
Clin Infect Dis. 2006 May 1;42(9):1325-32. (PMID: 16586393)
Invest Ophthalmol Vis Sci. 2008 May;49(5):1784-90. (PMID: 18436813)
AIDS. 2012 Jun 1;26(9):1115-20. (PMID: 22382147)
AIDS. 2012 Jul 31;26 Suppl 1:S1-5. (PMID: 22713477)
J Infect Dis. 2012 Jun;205 Suppl 3:S355-61. (PMID: 22577208)
Invest Ophthalmol Vis Sci. 2008 Apr;49(4):1362-6. (PMID: 18385051)
AIDS. 2005 Dec 2;19(18):2141-8. (PMID: 16284464)
Lancet. 2008 Apr 26;371(9622):1417-26. (PMID: 18387667)
Annu Rev Med. 2011;62:141-55. (PMID: 21090961)
Curr Eye Res. 2003 Sep;27(3):143-9. (PMID: 14562179)
Eur Heart J. 2007 Aug;28(16):1984-92. (PMID: 17626032)
Brain. 2006 Jan;129(Pt 1):182-8. (PMID: 16317022)
J Infect Dis. 2012 Jun;205 Suppl 3:S368-74. (PMID: 22577210)
JAMA. 2002 May 15;287(19):2528-33. (PMID: 12020333)
Am J Ophthalmol. 2012 Mar;153(3):434-444.e1. (PMID: 22019225)
Top HIV Med. 2009 Sep-Oct;17(4):118-23. (PMID: 19890183)
JAMA. 2002 Mar 6;287(9):1153-9. (PMID: 11879113)
J Infect Dis. 2012 Jun;205 Suppl 3:S375-82. (PMID: 22577211)
Curr Opin HIV AIDS. 2009 May;4(3):176-82. (PMID: 19532047)
Invest Ophthalmol Vis Sci. 2006 Jun;47(6):2341-50. (PMID: 16723443)

United Kingdom WT_ Wellcome Trust; MR/K012126/1 United Kingdom MRC_ Medical Research Council; 088590 United Kingdom WT_ Wellcome Trust; 090354/Z/09/Z United Kingdom WT_ Wellcome Trust

0 (Anti-HIV Agents)

Date Created: 20121220 Date Completed: 20130611 Latest Revision: 20220129

20221213

PMC3519635

10.1371/journal.pone.0051405

23251521