van Vonderen, Marit G. A.;
Hassink, Elly A. M.;
van Agtmael, Michiel A.;
Stehouwer, Coen D. A.;
Danner, Sven A.;
Reiss, Peter;
Smulders, Yvo
Increase in Carotid Artery Intima-Media Thickness and Arterial Stiffness but Improvement in Several Markers of Endothelial Function after Initiation of Antiretroviral Therapy
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Medientyp:
E-Artikel
Titel:
Increase in Carotid Artery Intima-Media Thickness and Arterial Stiffness but Improvement in Several Markers of Endothelial Function after Initiation of Antiretroviral Therapy
Beteiligte:
van Vonderen, Marit G. A.;
Hassink, Elly A. M.;
van Agtmael, Michiel A.;
Stehouwer, Coen D. A.;
Danner, Sven A.;
Reiss, Peter;
Smulders, Yvo
Beschreibung:
<p>Background. The risk of cardiovascular disease in human immunodeficiency virus (HlV)-infected patients is an increasing concern. We studied the changes in vascular properties after the initiation of combination antiretroviral therapy (cART) as well as the contribution of different drug classes. Methods. cART-naive men were randomized to receive either lopinavir/ ritonavir (LPV/ r) plus zidovudine/ lamivudine (ZDV/ 3TC) (n = 19) or LPV/ r plus nevirapine (NVP) (n = 18). Carotid artery intima-media thickness (C-IMT), arterial stiffness (distensibility coefficients [ DCs] and compliance coefficients [ CCs] of the carotid, femoral, and brachial arteries; carotid elastic modulus; and augmentation index), and markers of endothelial function (soluble vascular cell adhesion molecule [ sVCAM]-l, intercellular adhesion molecule [ sICAM]-l, plasma von Willebrand factor (vWF) antigen, and plasminogen activator inhibitor-1 antigen) and inflammation (high-sensitivity C-reactive protein) were measured before the initiation of cART and after 3,12, and 24 months of cART. Results. C-IMTincreasedby0.061 ± 0.016mm (P < .001) intheZDV/ 3TC/ LPV/ rarmandby0.044 ± 0.018 mm² (P= .012) in the NVP/ LPV/ r arm (data are estimated means ± SEs). Femoral artery DC (-1.66 ± 0.78 X 10⁻³ / kPa [ P = .035]) andCC (-0.11 ± 0.053 mm² / kPa [ P = .043]) decreased in the ZDV/ 3TC/ LPV/ r arm and femoral DC decreased in the NVP/ LPV/ r arm (-1.72 ± 0.85 X 10⁻³ / kPa [ P = .046]), with no significant difference in C-IMT or arterial stiffness between arms. sVCAM-1, sICAM-1, and vWF levels decreased significantly in both groups. Conclusion. C-IMT and femoral artery stiffness increased after the initiation of cART, whereas several markers of endothelial function improved, regardless of the composition of cART. Trial registration. ClinicalTrials.gov identifier: NCT00122226.</p>