Improvement in Aortic Stiffness After 9 Months of Antiretroviral Therapy in Treatment-Naïve People Living with HIV.

Authors

Pieter-Paul S Robbertse, Anton F Doubell, Christelle Ackermann, Innocent Maposa, Philip G Herbst

Published in

Diagnostics (Basel, Switzerland). Volume 16. Issue 17. Sep 07, 2026. Epub Sep 07, 2026.

Abstract

Background: People living with HIV (PLWH) are at increased risk of cardiovascular disease (CVD). Aortic stiffness measured with carotid-femoral pulse wave velocity (PWV) is a validated predictor of CVD and has been shown to be elevated in PLWH at HIV diagnosis. Objectives: To prospectively evaluate the effect of 9 months of contemporary antiretroviral therapy (ART) on aortic stiffness in newly diagnosed PLWH. Methods: A group of ART-naïve PLWH with modest cardiovascular risk and without known CVD were recruited at the time of HIV diagnosis. Aortic stiffness was measured using carotid-femoral PWV (ViCorder, Skidmore Medical, UK) before ART initiation and after 9 months on treatment. Results: Seventy-three participants were analysed (mean age 32 ± 7 years; 45% female). PWV decreased significantly after 9 months of ART (5.93 ± 1.0 vs. 5.69 ± 1.0 m/s; p = 0.01) with increased aortic distensibility (0.36 [IQR 0.30 to 0.46] vs. 0.40 [IQR 0.34 to 0.50] mmHg^-1; p = 0.02). The reduction in PWV remained significant after adjustment for covariates (mean change -0.26 m/s; 95% CI -0.07 to -0.45; p = 0.01). Conclusions: Aortic stiffness improved in a group of newly diagnosed PLWH after ART initiation at 9 months, in keeping with a modifiable component of HIV-associated vascular dysfunction. The findings are consistent with reversible functional vascular abnormality, potentially mediated by changes in vasomotor tone, although it is unknown if this effect will be sustained long-term. The trajectory of aortic stiffness in PLWH and the mechanisms that underpin vasomotor tone require further study.

PMID:
42739298
Bibliographic data and abstract were imported from PubMed on 15 Sep 2026.

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