Abstract 13277: Hiv and Race Are Independently Associated With Endothelial Dysfunction

Abstract

Objective: Assessing the vascular function in HIV + compared to HIV - with assessment of body composition, inflammation, and gut integrity markers. Introduction: HIV and ART are associated with an increased risk of CVD. Thus, the need for a non-invasive test to detect increased risk or early signs of CVD. Hypothesis: HIV and non-white race are independently associated with vascular dysfunction. High viral load, BMI, and inflammation damage endothelial function. Methods: We included participants ≥18 years, with peripheral arterial tonometry testing (EndoPAT2000) between 2014-2022. HIV + had a stable ART regimen, and a VL ≤400 c/mL. We measured the vessel’s adaptability with Reactive Hyperemia Index (RHI) (normal>1.67) and elasticity with Augmentation Index (AI) (normal<-10). We assessed markers of systemic inflammation, immune activation, and gut integrity. We used linear mixed models to estimate endothelial dysfunction with a significant p-value<0.05. Results: Overall, 511 participants (296 HIV+ and 215 HIV-) were included. The estimated RHI among HIV+ was 13% lower (p=0.01) compared to HIV-. In Non-White, the estimated RHI was 9% lower (p=0.001) than in White. Every 1% increase in BMI we would expect RHI to increase 0.17% (p=0.01). At the time of EndoPAT, the estimated RHI was 8% lower (p=0.04) among PI antiretroviral therapy use compared to HIV+ who were taking NRTI or NNRTIs. The estimated odds of having endothelial dysfunction (RHI ≤ 1.67) is 1.56 times greater (95% CI: 1.05, 2.31) in Non-White compared to White, independent of HIV status [OR=1.4 (95% CI: 0.94, 2.13)]. There was not enough evidence to suggest that inflammation, gut, or monocyte markers, current or nadir CD4, duration of HIV, or current treatment with NRTI or NNRTIs at the time of EndoPat was associated with endothelial dysfunction. Conclusions: HIV and non-white race are independently associated with endothelial dysfunction. PI use was associated with vascular dysfunction in all racial groups.