Original Research

Immune activation and arterial stiffness in lean adults with HIV on antiretroviral therapy

Longa Kaluba, Fastone Goma, Chris Guure, Sody Munsaka, Wilbroad Mutale, Douglas C. Heimburger, Theresa Chikopela, John R. Koethe
Southern African Journal of HIV Medicine | Vol 22, No 1 | a1190 | DOI: https://doi.org/10.4102/sajhivmed.v22i1.1190 | © 2021 Longa Kaluba, Fastone Goma, Chris Guure, Sody Munsaka, Wilbroad Mutale, Douglas C. Heimburger, Theresa Chikopela, John R. Koethe | This work is licensed under CC Attribution 4.0
Submitted: 04 November 2020 | Published: 19 March 2021

About the author(s)

Longa Kaluba, School of Medicine, Cavendish University Zambia, Lusaka, Zambia
Fastone Goma, Eden University, Lusaka; Department of Physiological Sciences, School of Medicine, University of Zambia, Lusaka, Zambia
Chris Guure, Department of Biostatistics, School of Public Health, University of Ghana, Legon, Ghana
Sody Munsaka, Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
Wilbroad Mutale, Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia
Douglas C. Heimburger, Vanderbilt Institute for Global Health and Department of Medicine, Vanderbilt University Medical Centre, Nashville, TN, United States
Theresa Chikopela, Department of Human Physiology, Faculty of Medicine, Lusaka Apex University, Lusaka, Zambia
John R. Koethe, Vanderbilt Institute for Global Health and Department of Medicine, Vanderbilt University Medical Centre, Nashville, TN, United States


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Abstract

Background: Greater T-cell activation was associated with reduced vascular compliance amongst persons living with HIV (PLWH) especially among overweight and obese individuals. There is a paucity of data regarding immune activation and arterial stiffness amongst PLWH in sub-Saharan Africa (SSA).

Objective: To determine the association between immune activation and arterial stiffness in lean PLWH in SSA.

Method: Forty-eight human immunodeficiency virus positive (HIV+) adults on antiretroviral therapy (ART) >5 years and 26 HIV-negative adults, all with BMI < 25 kg/m2 and no history of CVD, were enrolled. The relationship of vascular compliance with circulating CD4+ and CD8+ naïve, memory, activated and senescent T cells, and serum 8-isoprostane was assessed by HIV status.

Results: Increased immune activation was observed in the CD4+ and CD8+ T cells of PLWH, 16.7% vs. 8.9% and 22.0% vs. 12.4% respectively; p < 0.001 (both). Furthermore, a higher proportion of senescent CD4+ T cells were associated with a lower carotid-femoral pulse wave velocity (cfPWV; p = 0.01), whilst a higher proportion of activated CD8+ T cells were associated with a lower carotid-radial pulse wave velocity (crPWV; p = 0.04), after adjustment for BMI and age. However, PLWH also had a higher median carotid-femoral augmentation index (cfAiX) (21.1% vs. 6.0%; p < 0.05) in comparison to their HIV controls.

Conclusion: Our population of lean PLWH had increased immune activation and higher cfAiX, a marker of arterial stiffness, compared to HIV-negative persons. The negative association between immune activation and arterial stiffness as measured by crPWV in PLHW on long-term treatment needs further elucidation.


Keywords

endothelial dysfunction; immune activation; lean adults; antiretroviral therapy; arterial stiffness

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