High platelet count and high low-density lipoprotein level may be an independent marker of increased arterial stiffness in adult HIV-infected persons

Introduction
Cardiovascular disease is an increasing and leading cause of morbidity and mortality in people living with human immunodeficiency virus (PLHIV) infection. Arterial stiffness is a predictor of endothelial dysfunction in subclinical patients. The aim of this study was to assess which of the laboratory parameters performed during the standard PLHIV medical care visit may be associated with increased arterial stiffness.

Material and methods
Thirty HIV-1-infected adult patients (four females and 26 males) were recruited to this study. Endothelial dysfunction and arterial stiffness assessment was performed using the Endo-PAT 2000 device (ITAMAR®). Baseline pressure waveform obtained by peripheral arterial tonometry (PAT) was used to calculate the augmentation index (AI). AI values were corrected for heart rate using an arbitrarily defined reference heart rate of 75 bpm (AI@75).

Results
Our analysis included 30 patients. Men comprised 87% (n = 26), 16 patients (53%) were on combined antiretroviral therapy (cART), 11 patients (36.7%) had undetectable HIV viral load, 15 patients (50%) had active or previous hepatitis C virus (HCV) or hepatitis B virus (HBV) co-infection, and 16 patients (53%) smoked cigarettes. In univariate analysis, only total platelet count and effective cART use influenced arterial stiffness in PLHIV. In multivariate analysis, the variables with confirmed statistical significance were low-density lipoprotein (LDL) (p = 0.040; slope estimate = 6.30 per mmol/l of LDL) and platelet (PLT) count (p = 0.003; slope estimate = 0.13 per 109/l of platelet count).

Conclusions
We showed that high LDL concentration and high total platelet count may be an independent risk factor of the subclinical atherosclerotic disease in PLHIV. Moreover, we observed a possible negative influence of cART on arterial stiffness.