Hemorheology in asymptomatic HIV‐infected patients

Abstract

Although cardiac and vascular complications have been recognized among patients infected with the Human Immunodeficiency Virus‐1 (HIV‐1), their vascular biology and rheology have not been studied. Rheology of red blood cells (RBC) was assessed with an erythroaggregometer in 22 HIV‐1 infected asymptomatic patients (pts) and 17 healthy HIV negative controls (C). All participants were normotensive, nondiabetics, had normal lipid levels and had an hematocrit ranging from 37 to 44% and hemoglobin levels ≥12 g/100 ml. Patients had a shorter RBC aggregation characteristic time than controls (1.49±0.17 vs. 2.04±0.41 s, p=0.001) and an increased disaggregation shear rate (166±34.9 vs. 122±25.4 s⁻¹, p=0.001). This hyperaggregation tendancy was associated with increased γ‐globulin (18.3±3.3 vs. 13.7±1.9 g/l, p=0.01) and fibrinogen (3.52±0.57 vs 3.03±0.48 g/l, p=0.003) levels and with an increased erythrocyte sedimentation rate (ESR) (25±14.3 vs. 12.3±7.5 mm, p=0.02). Even in patients with ESRs ranging within normal values (≤20 mm), the aggregation characteristic time was found lower in patients than in controls (p=0.004). There was no correlation between these rheological changes and the CD4+ T‐cell count. The 17 patients receiving an antiviral therapy had lower CD4+ T‐cell counts than their 5 untreated counterparts (244.7±167 vs. 410±106/mm³, p=0.025), and a higher disaggregation shear rate (177.4±38.2 vs. 127±25.4, p=0.01). Thus, an impairment of rheological characteristics is observed in asymptomatic HIV‐1 infected patients in association with changes in plasma proteins.