Association of HIV Infection and Antiretroviral Therapy With Arterial Stiffness: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Incidence of cardiovascular disease in people living with HIV has increased as overall survival has improved because of combination antiretroviral therapy (cART). Arterial stiffness is a composite indicator of cardiovascular disease risk independent of traditional risk factors. We aimed to synthesize the evidence on the relation of HIV and of cART to arterial stiffness. Medline, Embase, CINAHL, PubMed, and Cochrane Libraries were systematically searched for studies relating HIV/cART to arterial stiffness until June 2019. A standardized extraction form was used to collect data from published reports. Random-effects meta-analyses were performed to produce standardized mean differences and 95% CIs from studies reporting carotid-femoral pulse wave velocity. We retrieved 995 citations. Seventy-four studies (N=18 711 participants/13 119 with HIV) were included: 59 cross-sectional, 9 cohort, and 6 randomized trials. In meta-analyses of 17 studies, arterial stiffness was found to be elevated overall in individuals with HIV relative to controls (standardized mean difference, 0.44 m/s [95% CI, 0.25–0.63]) and in cART-treated versus untreated individuals with HIV (standardized mean difference, 0.35 m/s [95% CI, 0.13–0.57]). Several studies suggested that cumulative exposure to cART is associated with a continual increase in arterial stiffness. However, early initiation of treatment might improve arterial stiffness later in life. The results highlight the need for monitoring of cardiovascular risk in this population. The cross-sectional nature of most studies (59/74) mainly allowed for the exploration of associations; large longitudinal studies are needed to confirm the observed associations and establish causality between HIV/cART and arterial stiffness.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.006 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".