With or without ART, CVD risk matters

Session 0-4 Complications from Head to Toe

Early Antiretroviral Therapy Does Not Improve Vascular Function: A START Substudy. Abstract 41

Presenter: Jason V. Baker (Minneapolis, MN, USA)

They utilised diastolic aspect of cardiac BP waveforms to assess elasticity and vessel function.

Participants were generally a young cohort in their 30s and with CD4 counts >600

CVD (Cardio-vascualr disease) risk was low for the study cohort that was on ARVs, but was slightly increased for those participants that were in the ARV deferred group.

For HIV +ve patients consistent changes were noted across all age groups. 

It was notable that both HIV +ve groups (Those on ARVs and those in deferred arm) had lower elasticity baseline in comparison to the general (non-HIV) population, from CARDIA.

No specific difference in elasticity between ARV and deferred HIV +ve groups.

Overall the findings of the substudy did not show any benefit on vascular elasticity from commencing ART early. It did however highlight how vascularity is compromised within HIV +ve patients and hence for all our HIV +ve patients regardless of age we should take assessment of their CVD risk seriously and conduct this routinely, even for the young of age and those with suppressed viral loads and good CD4 counts.