TY - JOUR
T1 - Endothelial dysfunction, a predictor of cardiovascular disease in HIV patients on antiretroviral therapy
T2 - A systematic review and meta-analysis
AU - Strauss, Kay Lee E.
AU - Phoswa, Wendy N.
AU - Lebelo, Sogolo L.
AU - Modjadji, Perpetua
AU - Mokgalaboni, Kabelo
N1 - Publisher Copyright:
© 2024 The Author(s)
PY - 2024/2
Y1 - 2024/2
N2 - Aim Although antiretroviral therapy (ART) is available, the rate of new HIV infections is alarming. With this trend, it is anticipated that the use of ART will continue to rise, potentially resulting in associated vascular disorders. Therefore, we aimed to examine the impact of ART on endothelial function in people living with HIV (PLHIV), a predictor of cardiovascular diseases. Method: A comprehensive search for evidence was made on PubMed and Scopus on May 06, 2023, following the Preferred Reporting Items for Systematic Review and Meta-analysis. Cochrane and Newcastle–Ottawa quality assessment scales were used to evaluate quality, while the metaHun web tool and Review Manager version 5.4.1 were used for analysis. Subgroup, sensitivity, and publication bias were conducted for each outcome measure. Results: We identified 37 studies, including a sample size of 3700 with 2265 individuals on ART. The analyzed evidence showed a large significant effect of ART on vascular cell adhesion molecule-1, with a standardized mean difference (SMD) of −1.23 (95 % CI: −1.72, −0.74; p = 0.0013). Similarly, a significant medium effect of ART was observed on intercellular cell adhesion molecule-1 in PLHIV, with an SMD of −1.28 (95 % CI: −2.00, −0.56; p = 0.0231) compared to the control group. Furthermore, ART exhibited a significant but small effect on flow-mediated dilation (FMD) with an SMD of −0.40 (95 % CI: −0.62, −0.19, p = 0.0159). Conclusion: Our findings show an improved endothelial function in PLHIV on ART, as demonstrated by reduced adhesion molecules; however, ART exhibited a small effect on FMD, thus suggesting PLHIV on ART may still be at risk of endothelial dysfunction and further cardiovascular diseases.
AB - Aim Although antiretroviral therapy (ART) is available, the rate of new HIV infections is alarming. With this trend, it is anticipated that the use of ART will continue to rise, potentially resulting in associated vascular disorders. Therefore, we aimed to examine the impact of ART on endothelial function in people living with HIV (PLHIV), a predictor of cardiovascular diseases. Method: A comprehensive search for evidence was made on PubMed and Scopus on May 06, 2023, following the Preferred Reporting Items for Systematic Review and Meta-analysis. Cochrane and Newcastle–Ottawa quality assessment scales were used to evaluate quality, while the metaHun web tool and Review Manager version 5.4.1 were used for analysis. Subgroup, sensitivity, and publication bias were conducted for each outcome measure. Results: We identified 37 studies, including a sample size of 3700 with 2265 individuals on ART. The analyzed evidence showed a large significant effect of ART on vascular cell adhesion molecule-1, with a standardized mean difference (SMD) of −1.23 (95 % CI: −1.72, −0.74; p = 0.0013). Similarly, a significant medium effect of ART was observed on intercellular cell adhesion molecule-1 in PLHIV, with an SMD of −1.28 (95 % CI: −2.00, −0.56; p = 0.0231) compared to the control group. Furthermore, ART exhibited a significant but small effect on flow-mediated dilation (FMD) with an SMD of −0.40 (95 % CI: −0.62, −0.19, p = 0.0159). Conclusion: Our findings show an improved endothelial function in PLHIV on ART, as demonstrated by reduced adhesion molecules; however, ART exhibited a small effect on FMD, thus suggesting PLHIV on ART may still be at risk of endothelial dysfunction and further cardiovascular diseases.
KW - Antiretroviral therapy
KW - Endothelial function
KW - Flow-mediated dilation
KW - HIV
KW - Intercellular adhesion molecules
KW - Vascular adhesion molecules
UR - http://www.scopus.com/inward/record.url?scp=85182347553&partnerID=8YFLogxK
U2 - 10.1016/j.thromres.2023.12.011
DO - 10.1016/j.thromres.2023.12.011
M3 - Review article
C2 - 38211378
AN - SCOPUS:85182347553
SN - 0049-3848
VL - 234
SP - 101
EP - 112
JO - Thrombosis Research
JF - Thrombosis Research
ER -