What is it about?
HIV infection is associated with an increased risk of cardiovascular disease, but the mechanisms linking HIV infection to vascular complications are complex. This study investigated biomarkers of endothelial activation and inflammation in Black South African adults living with HIV who had not yet started antiretroviral therapy. We examined how these biomarkers related to CD4 counts and viral load, and also investigated how they changed following initiation of antiretroviral therapy.
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Why is it important?
We found evidence of endothelial activation in people with untreated HIV infection. Participants with lower CD4 counts had higher levels of several endothelial and inflammatory biomarkers, including ICAM-1, VCAM-1, TNF-α and von Willebrand factor. Within the HIV-positive group, VCAM-1 was associated with lower CD4 counts, while von Willebrand factor was associated with higher viral load. Following initiation of antiretroviral therapy, ICAM-1 and VCAM-1 decreased, whereas several inflammatory markers increased. These findings suggest that HIV-associated vascular effects are linked not only to inflammation but also to immune dysregulation and viral burden. Understanding these relationships may help explain why cardiovascular complications remain an important consideration in people living with HIV.
Perspectives
Endothelial activation may represent an important link between HIV infection, immune dysfunction and long-term cardiovascular risk. The findings also highlight that different components of the vascular and inflammatory response may behave differently following antiretroviral therapy. Further research is needed to understand how persistent endothelial activation and inflammation relate to cardiovascular outcomes in people living with HIV, particularly in populations that remain underrepresented in biomedical research.
Dr Catherine Worsley
University of Pretoria
Read the Original
This page is a summary of: Biomarkers of Endothelial Activation in Black South African HIV-Positive Subjects are Associated with Both High Viral Load and Low CD4 Counts, AIDS Research and Human Retroviruses, February 2022, Mary Ann Liebert Inc,
DOI: 10.1089/aid.2021.0052.
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