Prevalence of endothelial dysfunction in acquired immune deficiency syndrome patients and its correlation with degree of immunodeficiency

Authors

  • Zorinsangi Varte Department of Medicine, Mizoram Institute of Medical Education and Research (MIMER), Falkawn - 796005, Aizawl, Mizoram, India
  • Naveen P. Department of Physiology, Mizoram Institute of Medical Education and Research (MIMER), Falkawn - 796005, Aizawl, Mizoram, India
  • Wendy L. Ralte Department of Radio-Diagnosis, Mizoram Institute of Medical Education and Research (MIMER), Falkawn - 796005, Aizawl, Mizoram, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20192087

Keywords:

AIDS, Endothelial dysfunction, Flow mediated vasodilatation, HIV

Abstract

Background: Number of factors play a role in endothelial dysfunction observed in AIDS patients, which can lead to atherosclerosis along with cardiovascular mortality and morbidity. Human immunodeficiency virus (HIV), the etiologic agent of AIDS causes several vascular disorders characterized by an evident activation and perturbation of endothelial cells. Currently, there is lack of data in the Indian literature regarding study of endothelial dysfunction in HIV patients. The purpose of our research was to study the prevalence of endothelial dysfunction in HIV/AIDS patients.

Methods: The study comprises a total number of 60 adult HIV positive patients of both sex (male and female) with confirmed HIV seropositivity. The patients were divided into two groups of 30 each, depending on the degree of immune dysfunction (CD 4 cell counts). Group I- patients with CD 4+T cell count>200/µl and group II-patients with CD 4+T cell count<200/µl. These patients were subjected to detailed clinical examination and markers of endothelial dysfunction-flow mediated vasodilatation (FMD) of brachial artery, S. nitrite and C-reactive protein (CRP) were performed.

Results: The defect in endothelial function was most prevalent in patients with more severe immunosuppression. FMD of brachial artery was decreased in patients with CD 4+T cell count < 200/µl (7.07±2.89, p=0.00). S. nitrite was also significantly lower in group II patients (26.43±15.38), and these patients also showed more CRP positivity and higher CRP titres ranging from 1.2 mg/dl to 9.6 mg/dl.

Conclusions: The defect in endothelial function was most prevalent in patients with more severe immunosuppression. FMD of brachial artery was decreased in patients with CD 4+T cell count <200/µl (7.07±2.89, p=0.00). S. nitrite was also significantly lower in group II patients (26.43±15.38), and these patients also showed more CRP positivity and higher CRP titres ranging from 1.2 mg/dl to 9.6 mg/dl.

References

Rubanyi GM. The role of endothelium in cardiovascular homeostasis and diseases. J Cardiovasc Pharmac. 1993;22:S1-14.

Moncada S, Higgs A. The L-arginine-nitric oxidase pathway. N Engl J Med. 1993;329:2002-2012.

Shimokawa H. Primary endothelial dysfunction: atherosclerosis. J Mol Cellul Cardio. 1999;31(1):23-7.

Seigneur M, Constans J, Blann A, Renard M, Pellegrin JL, Amiral J, et al. Soluble adhesion molecules and endothelial cell damage in HIV infected patients Thromb. Haemost. 1997;77:646-9.

Lafeuillade A. Alessi MC, Poizot-Martin I, Boyer-Neumann C, Zandotti C, Quilichini R, et al. Endothelial cell dysfunction in HIV infection. J Acquir Immune Defic Syndr. 1992;5:127-31.

Lüscher TF. The endothelium as a target and mediator of cardiovascular disease. Europ J Clinic Investig. 1993;23(11):670-85.

Harrison DG. Endothelial dysfunction in atherosclerosis. Basic Res Cardiol. 1994;89(1):87-102.

Moshage H, Kok B, Huizenga JR, Jansen P. Nitrite and nitrate determinations in plasma: a critical evaluation. Clin Chem. 1995;41:892-6.

Sármán B, Tóth M, Somogyi A. Role of endothelin‐1 in diabetes mellitus. Diab/Metab Reviews. 1998;14(2):171-5.

Lau B, Sharrett AR, Kingsley LA, Post W, Palella FJ, Visscher B, et al. C-reactive protein is a marker for human immunodeficiency virus disease progression. Arch Intern Med. 2006;166(1):64-70.

Hadigan C, Meigs JB, Corcoran C, Rietschel P, Piecuch S, Basgoz N, et al. Metabolic abnormalities and cardiovascular disease risk factors in adults with human immunodeficiency virus infection and lipodystrophy. Clinic Infect Dis. 2001;32(1):130-9.

Schalkwijk CG, Poland DCW, van Dijk W, Kok A, Emeis JJ, Dräger AM, et al. Plasma concentration of C-reactive protein is increased in type I diabetic patients without clinical macroangiopathy and correlates with markers of endothelial dysfunction: evidence for chronic inflammation. Diabetol. 1999;42:351-7.

Anderson TJ, Uehata A, Gerhard MD. Close relationships of endothelial function in the human coronary and peripheral circulations. J Am Coll Cardiol. 1995;26:1235-41.

Enderle MD, Balletshofer B, Schmulling RM, Haring HU, Pfohl M. Early detection of atherosclerosis in type 2 diabetic patients using high resolution ultrasound. Ultraschall Med. 1998;19:16-21.

Wendelhag I, Gustavsson T, Suurkula M, Berglund G, Wikstrand J. Ultrasound measurement of wall thickness in the carotid artery: fundamental principles and descriptions of a computerized analyzing system. Clin Physiol. 1991;11:565-77.

Bonnet D, Aggoun Y, Szezepanski I, Bellal N, Blanche S. Arterial stiffness and endothelial dysfunction in HIV-infected children. AIDS. 2004;18:1037-41.

de Larrañaga GF, Bocassi AR, Puga LM, Alonso BS, Benetucci JA. Endothelial markers and HIV infection in the era of highly active antiretroviral treatment. Thromb Res. 2003;110 (2-3):93-8.

Dolan SE, Hadigan C, Killilea KM, Sullivan MP, Hemphill L, Lees RS, et al. Increased cardiovascular disease risk indices in HIV-infected women. JAIDS. 2005;39(1):44-54.

Downloads

Published

2019-05-24

Issue

Section

Original Research Articles