Cutaneous microvessel circulation and vasomotion responses to local skin heating in women with HIV.

Abstract

BackgroundPatients infected with the human immunodeficiency virus (HIV) who are well treated by ART still suffer from many complications of microvascular dysfunction. Our previous ex vivo study reported that subcutaneous microvessels from women living with HIV had severe endothelial dysfunction. However, it is unknown whether the microvascular defect is more widespread. We tested the hypothesis that microvascular endothelial, neural and myogenic functions are impaired in women living with HIV compared to control women (control).MethodsWomen with HIV (n = 35) were compared to matched controls (n = 24). HIV infection was virally suppressed on antiretroviral therapy and both groups were enrolled in the DC Women’s Interagency HIV Study (DC – WIHS). Cutaneous blood flow (CBF) was measured by laser Doppler flowmetry (LDF) during an increase of local skin temperature from 33°C to 42°C. Vasomotion responses were analyzed using a wavelet transform to calculate the power of the frequency intervals associated with endothelial (0.0095 ‐0.012Hz), neural (0.021‐0.05Hz) and myogenic (0.051 ‐0.15Hz) activities of the Laser‐Doppler signal. Data are present as mean ± SEM.ResultCBF was increased in both groups with LH at 42°C, but the increases of CBF to heat was lower in HIV infected women than controls (13.9 ± 1.1 vs 15.6 ± 1.2 fold, p<0.05). Vasomotion activities were similar between groups at baseline (33°C) and increased in both groups with LH at 42°C, but the increase was less in HIV compared to controls (13.9 ± 1.1 vs 15.6 ± 1.2 fold change, P <0.05). Moreover, compared to the control group, HIV had lower wavelet amplitude during LH in endothelial (100±3.8 vs 149± 15 PU/Hz/min, P<0.05), neural (92 ± 5 vs 132 ±15 PU/Hz/min, P<0.05) and myogenic (46±3 vs 60 ±7 PU/Hz/min, P=NS) frequency intervals.ConclusionWomen living with HIV have impaired microvascular dysfunction with a complex derangement of microvascular circulatory regulation involving the endothelial, neural and myogenic components. Thus, fully preventing microvascular disease in HIV will require correction of widespread microvascular defects.Support or Funding InformationNational Heart, Lung, and Blood Institute (NHLBI), R01 HL134511