Abstract
Objective:Women may be disproportionately impacted by the negative effect of HIV on cerebrovascular risk. We examined the association of HIV, sex, menopause, and immune activation with cerebrovascular function among women with HIV (WWH) and at risk for HIV from the Women's Interagency HIV Study and men with HIV.Design:Cross-sectional.Methods:Participants were aged at least 40 years with coronary heart disease or at least one cardiometabolic risk factor. All persons with HIV were on antiretroviral therapy with undetectable viral load. Cerebral vasoreactivity was assessed by the transcranial Doppler breath-holding test, with lower vasoreactivity corresponding to worse cerebrovascular function. Menopausal status was determined by anti-Müllerian hormone level. We used mixed effects linear regression to identify factors associated with cerebral vasoreactivity.Results:Mean cerebral vasoreactivity was similar in WWH (n=33) and women at risk for HIV (n=16). A trend toward higher cerebral vasoreactivity in WWH compared with men with HIV (n=37) was no longer present after excluding women on estrogen replacement therapy (n=3). In women, menopausal status was not significantly associated with cerebral vasoreactivity. WWH with higher cardiovascular risk (-0.14 for each additional cardiometabolic risk factor, P=0.038), sCD163 (-0.20 per doubling, P=0.033), and proportion of CD4+CX3CR1+ T cells (-0.14 per doubling, P=0.028) had lower cerebral vasoreactivity.Conclusion:Among older women at high cardiovascular risk, women with virologically suppressed HIV and women at risk for HIV had similar cerebrovascular function. Our findings, which must be interpreted in the context of the small sample, highlight the contribution of traditional cardiometabolic risk factors and immune activation to cerebrovascular risk in WWH.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 257-266 |
| Number of pages | 10 |
| Journal | AIDS |
| Volume | 35 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 2 2021 |
Funding
The current study was supported by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health (NIH), through UCSF-CTSI grant number KL2 TR001870 and TR000143 and by the National Institute of Neurological Disorders and Stroke (NINDS), NIH, through grant number K23 NS105575 (F.C.C.). Data from this project was also supported by the Northern California site of the MACS-WIHS Combined Cohort Study (MPIs: Bradley Aouizerat, Jennifer Price, and Phyllis Tien), U01 HL146242. The MWCCS is funded primarily by the National Heart, Lung, and Blood Institute (NHLBI), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institute on Aging (NIA), National Institute of Dental & Craniofacial Research (NIDCR), National Institute of Allergy And Infectious Diseases (NIAID), National Institute of Neurological Disorders And Stroke (NINDS), National Institute of Mental Health (NIMH), National Institute on Drug Abuse (NIDA), National Institute of Nursing Research (NINR), National Cancer Institute (NCI), National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Deafness and Other Communication Disorders (NIDCD), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institute on Minority Health and Health Disparities (NIMHD), and in coordination and alignment with the research priorities of the NIH Office of AIDS Research (OAR). P.Y.H. is supported by K24 AI112393, and P.C.T. is supported by K24 AI108516. The work of I.S. and M.M. is supported by the intramural research program of NIAID, NIH. The contents of this work are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.
Keywords
- HIV
- cardiovascular risk
- cerebral vasoreactivity
- cerebrovascular function
- stroke
- women
ASJC Scopus subject areas
- Immunology and Allergy
- Immunology
- Infectious Diseases
