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Characteristics of glucose metabolism and endothelial status in young patients with perinatal HIV infection

https://doi.org/10.22328/2077-9828-2025-17-2-52-62

Abstract

The aim of the study: to assess the vascular endothelial status (based on brachial artery ultrasound data and the Celermajer test) and glucose metabolism markers (insulin, glucose levels, HOMA-IR index) in young patients with perinatal HIV infection.

Materials and methods. The study included 83 young HIV-infected patients aged 18 years or older registered at the St. Petersburg AIDS Center. The main group (n=57) consisted of patients with perinatal HIV infection (PHIV), while the control group (n=26) included individuals infected via sexual transmission.

Results and discussion. In the main group, 46 patients (80.7%) had normal blood glucose levels (3.3–5.5 mmol/L), compared to 11.6% in the control group. Normal insulin levels were observed in 84.2% of the main group and 77% of the control group. A pathological HOMA-IR index was significantly more frequent in the main group (p0.05). Both groups exhibited early signs of endothelial impairment at ages 20–25, with intima-media thickness (IMT) within normal ranges. However, males with PHIV showed significantly more frequent deviations toward increased IMT (p=0.049).

Conclusion. Markers of glucose metabolism disorders, insulin resistance, and vascular endothelial dysfunction were identified in young patients with perinatal and sexually acquired HIV. However, PHIV patients demonstrated earlier and more pronounced changes.

About the Authors

A. V. Samarina
Centre for Prevention and Control of AIDS and Infectious Diseases; First St. Petersburg State Medical University named after I. P. Pavlov
Russian Federation

St. Petersburg



E. J. Sereda
Centre for Prevention and Control of AIDS and Infectious Diseases; Children’s Research and Clinical Centre for Infectious Diseases
Russian Federation

St. Petersburg



V. V. Rassokhin
First St. Petersburg State Medical University named after I. P. Pavlov; St. Petersburg Pasteur Institute
Russian Federation

St. Petersburg



A. I. Ermakov
Centre for Prevention and Control of AIDS and Infectious Diseases
Russian Federation

St. Petersburg



O. V. Teslya
Centre for Prevention and Control of AIDS and Infectious Diseases
Russian Federation

St. Petersburg



References

1. Maksumova D.K., Salakhiddinov Z.S., Kodirov D.A. et al. Prevalence of lipid metabolism disorders in the HIV-infected population aged 20–69 years. Eurasian Cardiology Journal, 2019, No. 1, рр. 45–46 (In Russ.). https://doi.org/10.38109/2225-1685-2019-2S.

2. Alieva A.M., Sozykin A.V., Lyalina V.V. et al. Modern view on the problem of atherosclerosis in patients with HIV infection. Cardiological Bulletin, 2022, Vol. 17, No. 2, рр. 25–32 (In Russ.). https://doi.org/10.17116/Cardiobulletin2022170225.

3. D’Ascenzo F., Cerrato E., Biondi-Zoccai G. et al. Acute coronary syndromes in human immunodeficiency virus patients: a metaanalysis investigating adverse event rates and the role of anti — retroviral therapy // Eur. Heart J. 2012. Vol. 33, No. 7. Р. 875–880. doi: 10.1093/eurheartj/ehr456.

4. Barbaro G., da Silva E. // Rev. Assoc. Med. Bras. 2009. Vol. 55, No. 5. P. 621–630.

5. Boccara F., Lang S., Meuleman C. et al. // J. Amer. Coll. Cardiol. 2013. Vol. 61, Nо. 5. P. 511–523.

6. Triant V.A., Lee H., Hadigan C., Grinspoon S.K. Increased acute myocardial infarction rates and cardiovascular risk factors among patients with human immunodeficiency virus disease // J. Clin. Endocrinol. Metab. 2007. Vol. 92, No. 7. P. 2506–2512.

7. Sereda E.Zh., Samarina A.V., Ermakov A.I., Teslya O.V. Metabolic disorders in young people with perinatal HIV infection. Actual Issues of HIV Infection in Children: Proceedings of the International Scientific-Practical Conference, Saint Petersburg, September 14–15, 2023. St. Petersburg: Human and Health, 2023. Р. 121–122 (In Russ.)

8. Smit M., Brinkman K., Geerlings S. et al. Future challenges for clinical care of an ageing population infected with HIV: a modelling study // Lancet Infect. Dis. 2015. Vol. 15, No. 7. Р. 810–818. doi: 10.1016/S1473-3099(15)00056-0.

9. Shekhovtsova T.A., Duplyakov D.V. HIV infection and pathology of the cardiovascular system. Cardiovascular Therapy and Prevention, 2023, Vol. 22, No. 3, рр. 3370 (In Russ.). doi: 10.15829/1728-8800-2023-3370. EDN FYEYOH.

10. Neuhaus J., Jacobs D.R. Jr., Baker J.V. et al. Markers of inflammation, coagulation, and renal function are elevated in adults with HIV infection // J. Infect. Dis. 2010. Vol. 201. Р. 1788–1795. doi: 10.1086/652749.

11. Kuller L.H., Tracy R., Belloso W. et al. INSIGHT SMART Study Group. Inflammatory and coagulation biomarkers and mortality in patients with HIV infection // PLoS Med. 2008. Vol. 5. e203. doi: 10.1371/journal.pmed.0050203.

12. Koziolova N.A., Goryacheva O.G., Litsinger I.F. The role of inflammation in the formation of chronic heart failure in patients infected with human immunodeficiency virus. Russian Journal of Cardiology, 2022, Vol. 27, No. 2, рр. 4862 (In Russ.). https://doi.org/10.15829/1560-4071-2022-4862.

13. Matievskaya N.V., Tokunova I.O., Snezhitsky V.A. HIV infection and cardiovascular system pathology. Medical News, 2015, Vol. 6, рр. 6–12 (In Russ.)

14. Markov Kh.M. Molecular mechanisms of vascular endothelial dysfunction. Сardiology, 2005, No. 12, рр. 62–67 (In Russ.)

15. Dau B., Holodniy M. The Relationship Between HIV Infection and Cardiovascular Disease // Curr. Cardiol. Rev. 2008. Vol. 4. P. 203–218.

16. Hsue Y., Deeks S.G., Hunt P.W. Immunologic basis of cardiovascular disease in HIV-infected adults // JID. 2012. Vol. 205 (Suppl. 3). P. S375.

17. Rawdanowicz J., Pikto-Pietkiewicz W., Marczyńska M. Cardiovascular diseases associated with HIV infection and their management // Kardiologia Polska. 2013. Vol. 71, No. 11. P. 1183–1187.

18. Mdodo R., Frazier E.L., Dube S.R. et al. Cigarette smoking prevalence among adults with HIV compared with the general adult population in the United States: cross-sectional surveys // Ann. Intern. Med. 2015. Vol. 162, No. 5. Р. 335–344. doi: 10.7326/M14-0954.

19. Urunova D.M., Akhmedzhanova Z.I., Masalieva D.I. et al. Analysis of cardiovascular diseases in HIV infection. Cardiological Bulletin, 2022, Vol. 17, No. 2–2, рр. 114–115 (In Russ.). https://doi.org/10.17116/Cardiobulletin2022170225.

20. Abyshev R.A., Glukhov N.V., Rassokhin V.V. et al. Risk factors for cardiovascular diseases in the HIV-infected population. Part 1. HIV Infection and Immunosuppression, 2011, Vol. 3, No. 3, рр. 24–34 (In Russ.).

21. Abyshev R.A., Glukhov N.V., Rassokhin V.V. et al. Risk factors for cardiovascular diseases in the HIV-infected population. Part 2. HIV Infection and Immunosuppression, 2011, Vol. 3, No. 4, рр. 25–33 (In Russ.).

22. Xu Y., Chen X., Wang K. Global prevalence of hypertension among people living with HIV: a systematic review and metaanalysis // J. Am. Soc. Hypertens. 2017. Vol. 11. Р. 530–540. doi: 10.1016/j.jash.2017.06.004.

23. Arzhakova M.A., Shekhovtsova T.A., Duplyakov D.V. Coronary artery disease in HIV-infected patients. Rational Pharmacotherapy in Cardiology, 2019, Vol. 15, No. 6, рр. 900–905 (In Russ.). https://doi.org/10.20996/1819-6446-2019-15-6-900-905.

24. Lonardo A., Ballestri S., Guaraldi G. et al. Fatty liver is associated with an increased risk of diabetes and cardiovascular disease — Evidence from three different disease models: NAFLD, HCV and HIV // World J. Gastroenterol. 2016. Vol. 22, No. 44. Р. 9674–9693. doi: 10.3748/wjg.v22.i44.9674.

25. Kramer A.S., Lazzarotto A.R., Sprinz E. et al. Metabolic abnormalities, antirretroviral therapy, and cardiovascular disease in elderly patients with HIV // Arq. Bras Cardiol. 2009. Vol. 93, No. 5. Р. 561–568. doi: 10.1590/s0066–782x2009001100019.

26. Alvi R.M., Neilan A.M., Tariq N. et al. Protease Inhibitors and Cardiovascular Outcomes in Patients with HIV and Heart Failure // J. Am. Coll Cardiol. 2018. Vol. 72, No. 5. Р. 518–530. doi: 10.1016/j.jacc.2018.04.083.

27. Storozhakov G.I., Chervyakova Yu.B., Vereshchagina G.S., Fedotova N.M. Assessment of intima-media thickness in cardiovascular diseases. Medical Affairs, 2005, Vol. 1, рр. 46–49 (In Russ.).

28. Janzen J. The microscopic transitional zone between elastic and muscular arteries // Arch. Mal. Coeur Vaiss Pratique. 2014. Vol. 97. Р. 909–914.

29. Celermajer D.S., Sorensen K.E., Gooch V.M. et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis // The Lancet. 1992. Vol. 340. Р. 1111–1115. doi: 10.1016/01406736(92)93147-f.

30. Safonova P.V., Koltsova O.V. Treatment adherence in young people with perinatal HIV infection during transition from pediatric to adult care. HIV Infection and Immunosuppression, 2023, Vol. 15, No. 2, рр. 59–68 (In Russ.). https://doi.org/10.22328/2077-9828-2023-15-2-59-68. EDN YRXSUA.

31. Sereda E.Zh., Samarina A.V. Analysis of clinical and epidemiological indicators in patients with perinatal HIV infection who discontinued follow-up after transition to the adult department of the AIDS Center. Actual Issues of HIV Infection in Children: Proceedings of the International Scientific-Practical Conference, Saint Petersburg, September 14–15, 2023. St. Petersburg: Human and Health, 2023, рр. 119–120 (In Russ.).

32. Urunova D.M., Akhmedzhanova Z.I., Masalieva D.I. et al. Analysis of cardiovascular diseases in HIV infection. Cardiological Bulletin, 2022, Vol. 17, No. 2–2, рр. 114–115 (In Russ.). https://doi.org/10.17116/Cardiobulletin2022170225.

33. Belyalov F.I. (ed.). Clinical guidelines for cardiology and comorbid diseases. 11th ed. Moscow: Publishing house GEOTAR-Media, 2021 (Series «Library of a Medical Specialist») (In Russ.).

34. Grebenchikov O.A., Dolgikh V.T., Prokofiev M.D. Endothelial dysfunction as a key pathogenetic factor in the development of critical conditions. Vestnik Surgut State University. Medicine, 2021, Vol. 3, No. 49, рр. 51–60 (In Russ.).

35. Blázquez D., Ramos-Amador J.T., Saínz T. et al. Lipid and glucose alterations in perinatally-acquired HIV-infected adolescents and young adults // BMC Infect Dis. Vol. 15. Р. 119.

36. Bratt G., Brännström J., Missalidis C., Nyström T. Development of type 2 diabetes and insulin resistance in people with HIV infection: Prevalence, incidence and associated factors // PLoS One. 2021. Jun 30. Vol. 16, No. 6. Р. e0254079. doi: 10.1371/journal.pone.0254079. PMID: 34191847. PMCID: PMC8244855.

37. Kamtchum-Tatuene J., Mwangalika Kachingwe G., Mwandumba H.C., Solomon T., Benjamin L.A. Endothelial dysfunction and carotid atherosclerosis in Malawian adults: A cross-sectional study // eNeurologicalSci. 2020. Jun 28. Vol. 20. 100252. doi: 10.1016/j.ensci.2020.100252. PMID: 32642566. PMCID: PMC7334363.

38. Coelho A.R., Moreira F.A., Santos A.C. et al. Diabetes mellitus in HIV-infected patients: fasting glucose, A1c, or oral glucose tolerance test — which method to choose for the diagnosis? // BMC Infect. Dis. 2018. Vol. 18, No. 309. https://doi.org/10.1186/s12879-018-3221-7.

39. Høgh J., Gelpi M., Skovsgaard M.H. et al. HIV infection is associated with type 2 diabetes mellitus // J. Acquir Immune Defic. Syndr. 2021. Vol. 88, No. 4. Р. e32–5.

40. Behrens G., Dejam A., Schmidt H. et al. Impaired glucose tolerance, beta cell function and lipid metabolism in HIV patients under treatment with protease inhibitors // AIDS. 1999. Jul. 9. Vol. 13, No. 10. Р. F63–70. doi: 10.1097/00002030-199907090-00001. PMID: 10416516.

41. Andrade A.C., Cotter B.R. Endothelial function and cardiovascular diseases in HIV infected patient // Braz. J. Infect. Dis. 2006. Apr. Vol. 10, No. 2. Р. 139–145. doi: 10.1590/s1413-86702006000200012. PMID: 16878266.


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Samarina A.V., Sereda E.J., Rassokhin V.V., Ermakov A.I., Teslya O.V. Characteristics of glucose metabolism and endothelial status in young patients with perinatal HIV infection. HIV Infection and Immunosuppressive Disorders. 2025;17(2):52-62. (In Russ.) https://doi.org/10.22328/2077-9828-2025-17-2-52-62

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