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New Research Points to Links Between Viral Infections and Endothelial Dysfunction

The Association of CD4+ T-Cell Count on Cardiovascular Risk in Treated HIV Disease Emad Mogadam1, Kevin King2, Kimberly Shriner3, Karen Chu2, Anders Sondergaard2, Kristal Young4, Morteza Naghavi5, Robert A Kloner6, 7 1Division of Cardiovascular Medicine, Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA 2Huntington Medical Research Institutes, Pasadena, CA, USA 3Department of Medicine, Huntington Hospital, Pasadena, CA, USA 4Division of Cardiology, Department of Medicine, Huntington Hospital, Pasadena, CA, USA 5American Heart Technologies, Palo Alto, CA, USA 6Cardiovascular Research Institute, Huntington Medical Research Institutes, Pasadena, CA, USA 7Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA Corresponding Author: Kevin King, Huntington Medical Research Institutes, HMRI 686 S. Fair Oaks Ave, Pasadena, CA 91105, USA. Email: Abstract Objectives: HIV-infected population may have increased risk of cardiovascular disease. The prevalence of traditional cardiovascular disease risk factors such as hypertension, diabetes and dyslipidemia in HIV-infected individuals has made it difficult to assess the direct effects of HIV and immune factors on endothelial dysfunction and associated increased risk of atherosclerosis. The purpose of this study was to investigate indicators of endothelial dysfunction in an HIV cohort without hypertension and diabetes. Methods: We studied 19 HIV-infected patients between the ages of 25–76 years old with effectively suppressed viral load and without diagnosis of hypertension or diabetes. Endothelial function was measured by digital thermal monitoring of vascular reactivity using the VENDYS technique. Endothelial function was reported as vascular reactivity index. Systolic blood pressure and diastolic blood pressure at the time of VENDYS test were measured and latest lipid panels were recorded. The association between vascular reactivity index and CD4-T cells count, different antiretroviral therapy types (non-nucleoside reverse transcriptase, nucleoside reverse transcriptase, protease inhibitors, integrase inhibitors), vitamins use, systolic blood pressure, diastolic blood pressure, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol was investigated. Results: Mean vascular reactivity index was 1.87 ± 0.53. Vascular reactivity index, marker of endothelial dysfunction, showed a significant correlation with lower nadir CD4 count (p = 0.003) as well as low-density lipoprotein cholesterol (p = 0.02). No additional significant correlation between vascular reactivity index and the rest of the investigated variables was found. Conclusion: Vascular reactivity index, a clinical predictor of endothelial dysfunction, is associated with lower nadir CD4-T cell and low-density lipoprotein cholesterol in HIV-infected men with no history of hypertension or diabetes and before clinical evidence of cardiovascular disease. Keywords: HIV, nadir CD4-T cell count, endothelial dysfunction, VENDYS


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