Retinal arterioles narrow with increasing duration of anti-retroviral therapy in HIV infection: a novel estimator of vascular risk in HIV?

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dc.contributor.authorPathai, Sophiaen_ZA
dc.contributor.authorWeiss, Helen Aen_ZA
dc.contributor.authorLawn, Stephen Den_ZA
dc.contributor.authorPeto, Tundeen_ZA
dc.contributor.authorD'Costa, Leris Men_ZA
dc.contributor.authorCook, Colinen_ZA
dc.contributor.authorWong, Tien Yen_ZA
dc.contributor.authorGilbert, Clare Een_ZA
dc.date.accessioned2015-11-23T12:25:41Z
dc.date.available2015-11-23T12:25:41Z
dc.date.issued2012en_ZA
dc.description.abstractObjectives HIV infection is associated with an increased risk of age-related morbidity mediated by immune dysfunction, atherosclerosis and inflammation. Changes in retinal vessel calibre may reflect cumulative structural damage arising from these mechanisms. The relationship of retinal vessel calibre with clinical and demographic characteristics was investigated in a population of HIV-infected individuals in South Africa. METHODS: Case-control study of 491 adults ≥30 years, composed of 242 HIV-infected adults and 249 age- and gender-matched HIV-negative controls. Retinal vessel calibre was measured using computer-assisted techniques to determine mean arteriolar and venular diameters of each eye. RESULTS: The median age was 40 years (IQR: 35-48 years). Among HIV-infected adults, 87.1% were receiving highly active antiretroviral therapy (HAART) (median duration, 58 months), their median CD4 count was 468 cells/µL, and 84.3% had undetectable plasma viral load. Unadjusted mean retinal arteriolar diameters were 163.67±17.69 µm in cases and 161.34±17.38 µm in controls (p = 0.15). Unadjusted mean venular diameters were 267.77±18.21 µm in cases and 270.81±18.98 µm in controls (p = 0.07). Age modified the effect of retinal arteriolar and venular diameters in relation to HIV status, with a tendency towards narrower retinal diameters in HIV cases but not in controls. Among cases, retinal arteriolar diameters narrowed with increasing duration of HAART, independently of age (167.83 µm <3 years of HAART vs. 158.89 µm >6 years, p-trend = 0.02), and with a HIV viral load >10,000 copies/mL while on HAART (p = 0.05). HIV-related venular changes were not detected. CONCLUSIONS: Narrowing of retinal arteriolar diameters is associated with HAART duration and viral load, and may reflect heightened inflammatory and pro-atherogenic states of the systemic vasculature. Measurement of retinal vascular calibre could be an innovative non-invasive method of estimating vascular risk in HIV-infected individuals.en_ZA
dc.identifier.apacitationPathai, S., Weiss, H. A., Lawn, S. D., Peto, T., D'Costa, L. M., Cook, C., ... Gilbert, C. E. (2012). Retinal arterioles narrow with increasing duration of anti-retroviral therapy in HIV infection: a novel estimator of vascular risk in HIV?. <i>PLoS One</i>, http://hdl.handle.net/11427/15278en_ZA
dc.identifier.chicagocitationPathai, Sophia, Helen A Weiss, Stephen D Lawn, Tunde Peto, Leris M D'Costa, Colin Cook, Tien Y Wong, and Clare E Gilbert "Retinal arterioles narrow with increasing duration of anti-retroviral therapy in HIV infection: a novel estimator of vascular risk in HIV?." <i>PLoS One</i> (2012) http://hdl.handle.net/11427/15278en_ZA
dc.identifier.citationPathai, S., Weiss, H. A., Lawn, S. D., Peto, T., D’Costa, L. M., Cook, C., ... & Gilbert, C. E. (2012). Retinal arterioles narrow with increasing duration of anti-retroviral therapy in HIV infection: a novel estimator of vascular risk in HIV?. PloS one, 7(12), e51405. doi:10.1371/journal.pone.0051405en_ZA
dc.identifier.ris TY - Journal Article AU - Pathai, Sophia AU - Weiss, Helen A AU - Lawn, Stephen D AU - Peto, Tunde AU - D'Costa, Leris M AU - Cook, Colin AU - Wong, Tien Y AU - Gilbert, Clare E AB - Objectives HIV infection is associated with an increased risk of age-related morbidity mediated by immune dysfunction, atherosclerosis and inflammation. Changes in retinal vessel calibre may reflect cumulative structural damage arising from these mechanisms. The relationship of retinal vessel calibre with clinical and demographic characteristics was investigated in a population of HIV-infected individuals in South Africa. METHODS: Case-control study of 491 adults ≥30 years, composed of 242 HIV-infected adults and 249 age- and gender-matched HIV-negative controls. Retinal vessel calibre was measured using computer-assisted techniques to determine mean arteriolar and venular diameters of each eye. RESULTS: The median age was 40 years (IQR: 35-48 years). Among HIV-infected adults, 87.1% were receiving highly active antiretroviral therapy (HAART) (median duration, 58 months), their median CD4 count was 468 cells/µL, and 84.3% had undetectable plasma viral load. Unadjusted mean retinal arteriolar diameters were 163.67±17.69 µm in cases and 161.34±17.38 µm in controls (p = 0.15). Unadjusted mean venular diameters were 267.77±18.21 µm in cases and 270.81±18.98 µm in controls (p = 0.07). Age modified the effect of retinal arteriolar and venular diameters in relation to HIV status, with a tendency towards narrower retinal diameters in HIV cases but not in controls. Among cases, retinal arteriolar diameters narrowed with increasing duration of HAART, independently of age (167.83 µm <3 years of HAART vs. 158.89 µm >6 years, p-trend = 0.02), and with a HIV viral load >10,000 copies/mL while on HAART (p = 0.05). HIV-related venular changes were not detected. CONCLUSIONS: Narrowing of retinal arteriolar diameters is associated with HAART duration and viral load, and may reflect heightened inflammatory and pro-atherogenic states of the systemic vasculature. Measurement of retinal vascular calibre could be an innovative non-invasive method of estimating vascular risk in HIV-infected individuals. DA - 2012 DB - OpenUCT DO - 10.1371/journal.pone.0051405 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2012 T1 - Retinal arterioles narrow with increasing duration of anti-retroviral therapy in HIV infection: a novel estimator of vascular risk in HIV? TI - Retinal arterioles narrow with increasing duration of anti-retroviral therapy in HIV infection: a novel estimator of vascular risk in HIV? UR - http://hdl.handle.net/11427/15278 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15278
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0051405
dc.identifier.vancouvercitationPathai S, Weiss HA, Lawn SD, Peto T, D'Costa LM, Cook C, et al. Retinal arterioles narrow with increasing duration of anti-retroviral therapy in HIV infection: a novel estimator of vascular risk in HIV?. PLoS One. 2012; http://hdl.handle.net/11427/15278.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDesmond Tutu HIV Centreen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2012 Pathai et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherHighly-active antiretroviral therapyen_ZA
dc.subject.otherHIVen_ZA
dc.subject.otherRetinal vesselsen_ZA
dc.subject.otherViral loaden_ZA
dc.subject.otherHypertensionen_ZA
dc.subject.otherArteriolesen_ZA
dc.subject.otherHIV infectionsen_ZA
dc.subject.otherInflammationen_ZA
dc.titleRetinal arterioles narrow with increasing duration of anti-retroviral therapy in HIV infection: a novel estimator of vascular risk in HIV?en_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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