Original Research

Arterial stiffness is associated with oxidative stress and endothelial activation among persons with treated HIV in Zambia

Theresa Chikopela, Fastone Goma, Longa Kaluba, Wilbroad Mutale, Chris Guure, Douglas C. Heimburger, John R. Koethe
Southern African Journal of HIV Medicine | Vol 22, No 1 | a1298 | DOI: https://doi.org/10.4102/sajhivmed.v22i1.1298 | © 2021 Theresa Chikopela Chikopela, Fastone Goma, Longa Kaluba, Wilbroad Mutale, Chris Guure, Douglas C Heimburger, John R Koethe | This work is licensed under CC Attribution 4.0
Submitted: 12 August 2021 | Published: 28 October 2021

About the author(s)

Theresa Chikopela, Department of Physiology, Faculty of Medicine, Lusaka Apex Medical University, Lusaka, Zambia
Fastone Goma, Department of Physiological Sciences, School of Medicine, University of Zambia, Lusaka, Zambia
Longa Kaluba, School of Medicine, Cavendish University, Lusaka, Zambia
Wilbroad Mutale, Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia; and, Department of Internal Medicine, School of Medicine, University of Zambia, Lusaka, Zambia
Chris Guure, Department of Biostatistics, School of Public Health, University of Ghana, Legon, Ghana
Douglas C. Heimburger, Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America; and, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
John R. Koethe, Division of Infectious Diseases, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee, United States of America


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Abstract

Background: Cardiovascular disease (CVD) prevalence is rising among persons with HIV (PLWH) in sub-Saharan Africa. Oxidative stress and endothelial activation, resulting in reduced vascular compliance, are contributors to CVD risk. However, there is a paucity of vascular health data in this population.

Objectives: To assess the relationships of oxidative stress and endothelial activation with vascular stiffness among PLWH.

Method: Fifty-four PLWH on antiretroviral therapy > 5 years and 57 HIV-negative controls, all aged 18–45 years, were enrolled from the University Teaching Hospital, Lusaka, Zambia. Oxidative stress was measured by nitrotyrosine, a peroxynitrite biomarker, and endothelial activation by soluble intercellular adhesion molecule-1 (sICAM-1) plasma levels. Vascular compliance was measured using carotid-radial pulse wave velocity (crPWV) and arterial stiffness index (crASI).

Results: PLWH had higher sICAM-1 levels (median 345 ng/mL) compared to controls (275 ng/mL, p < 0.01), as well as higher nitrotyrosine levels (297 versus 182 nM; p = 0.02). Median crPWV was similar between the groups, but PLWH had higher crASI (2.4 versus 2.2 cm/ms; p < 0.05). After adjusting for age, fat mass, and blood pressure, the estimated effect of a one unit increase in nitrotyrosine on crPWV were twofold higher in the PLWH, but neither reached significance. In a model pooling all participants, there were significant differences in the relationship of nitrotyrosine with crPWV and crASI by HIV status.

Conclusion: PLWH in sub-Saharan Africa had significantly greater oxidative stress and endothelial activation compared to HIV-negative individuals. These factors may contribute to increased arterial stiffness and higher CVD prevalence in this population.


Keywords

Oxidative stress; endothelial activation, endothelial dysfunction; arterial stiffness, peroxynitrite

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