Endothelial Glycocalyx Integrity in Treatment-Naïve People Living with HIV before and One Year after Antiretroviral Treatment Initiation

Paraskevi C Fragkou; Ignatios Ikonomidis; Dimitrios Benas; Dimitra Kavatha; Charalampos D Moschopoulos; Konstantinos Protopapas; Gavriella Kostelli; John Thymis; Dionysia Mpirmpa; Irene Galani; Maria Tsakona; Chrysanthi Oikonomopoulou; George Theocharous; Vassilis G Gorgoulis; Parisis Gallos; Sotirios Tsiodras; Anastasia Antoniadou; Antonios Papadopoulos; Helen Triantafyllidi

doi:10.3390/v15071505

Endothelial Glycocalyx Integrity in Treatment-Naïve People Living with HIV before and One Year after Antiretroviral Treatment Initiation

Viruses. 2023 Jul 5;15(7):1505. doi: 10.3390/v15071505.

Authors

Paraskevi C Fragkou¹, Ignatios Ikonomidis², Dimitrios Benas², Dimitra Kavatha³, Charalampos D Moschopoulos³, Konstantinos Protopapas³, Gavriella Kostelli², John Thymis², Dionysia Mpirmpa², Irene Galani³, Maria Tsakona³, Chrysanthi Oikonomopoulou³, George Theocharous⁴, Vassilis G Gorgoulis⁴, Parisis Gallos⁵, Sotirios Tsiodras³, Anastasia Antoniadou³, Antonios Papadopoulos³, Helen Triantafyllidi²

Affiliations

¹ First Department of Critical Care and Pulmonary Services, Evangelismos Hospital, Athens Medical School, National and Kapodistrian University of Athens, 10676 Athens, Greece.
² Second Department of Cardiology, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece.
³ Fourth Department of Internal Medicine, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece.
⁴ Molecular Carcinogenesis Group, Department of Histology and Embryology, Athens Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.
⁵ Computational Biomedicine Laboratory, Department of Digital Systems, University of Piraeus, 18536 Piraeus, Greece.

Abstract

Endothelial glycocalyx (EG) derangement has been associated with cardiovascular disease (CVD). Studies on EG integrity among people living with HIV (PLWH), are lacking. We conducted a prospective cohort study among treatment-naïve PLWH who received emtricitabine/tenofovir alafenamide, combined with either an integrase strand transfer inhibitor (INSTI, dolutegravir, raltegravir or elvitegravir/cobicistat), or a protease inhibitor (PI, darunavir/cobicistat). We assessed EG at baseline, 24 (±4) and 48 (±4) weeks, by measuring the perfused boundary region (PBR, inversely proportional to EG thickness), in sublingual microvessels. In total, 66 consecutive PLWH (60 (90.9%) males) with a median age (interquartile range, IQR) of 37 (12) years, were enrolled. In total, 40(60.6%) received INSTI-based regimens. The mean (standard deviation) PBR decreased significantly from 2.17 (0.29) μm at baseline to 2.04 (0.26) μm (p = 0.019), and then to 1.93 (0.3) μm (p < 0.0001) at 24 (±4) and 48 (±4) weeks, respectively. PBR did not differ among treatment groups. PLWH on INSTIs had a significant PBR reduction at 48 (±4) weeks. Smokers and PLWH with low levels of viremia experienced the greatest PBR reduction. This study is the first to report the benefit of antiretroviral treatment on EG improvement in treatment-naïve PLWH and depicts a potential bedside biomarker and therapeutic target for CVD in PLWH.

Keywords: HIV; antiretroviral treatment; atherosclerosis; biomarkers; endothelial glycocalyx; integrase inhibitor; permeable boundary region; protease inhibitor.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Anti-HIV Agents* / therapeutic use
CD4 Lymphocyte Count
Cohort Studies
Endothelium* / drug effects
Endothelium* / pathology
Female
Glycocalyx* / drug effects
Glycocalyx* / pathology
HIV Infections* / drug therapy
HIV Infections* / pathology
Humans
Male
Middle Aged
Smoking
Viral Load

Substances

Anti-HIV Agents

Grants and funding

For P.C.F.: This research is co-financed by Greece and the European Union (European Social Fund—ESF) through the Operational Program «Human Resources Development, Education and Lifelong Learning» in the context of the project “Strengthening Human Resources Research Potential via Doctorate Research—2nd Cycle” (MIS-5000432), implemented by the State Scholarships Foundation (ΙΚΥ) (Grant number: 2018-050-0502-14473). This funding does not support a publication fee. None of the other authors received any funding for this project.