The Association Between HIV Infection and Carotid Intima-Media Thickness in the Era of Antiretroviral Therapy: A Meta-Analysis

Atherosclerosis remains a leading cause of mortality globally, and this is worse in people living with HIV (PLHIV). While the administration of antiretroviral therapy (ART) in this population has significant benefits, it is essential to acknowledge that it also has some undesired effects. This study...

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Main Authors: Angelina Nieuwoudt, Kay-Lee E. Strauss, Wendy N. Phoswa, Kabelo Mokgalaboni
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Viruses
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Online Access:https://www.mdpi.com/1999-4915/17/7/894
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author Angelina Nieuwoudt
Kay-Lee E. Strauss
Wendy N. Phoswa
Kabelo Mokgalaboni
author_facet Angelina Nieuwoudt
Kay-Lee E. Strauss
Wendy N. Phoswa
Kabelo Mokgalaboni
author_sort Angelina Nieuwoudt
collection DOAJ
description Atherosclerosis remains a leading cause of mortality globally, and this is worse in people living with HIV (PLHIV). While the administration of antiretroviral therapy (ART) in this population has significant benefits, it is essential to acknowledge that it also has some undesired effects. This study investigated the impact of ART on carotid intima-media thickness (CIMT) in PLHIV as a marker of early atherosclerosis. A literature search was conducted on the PubMed, Scopus, and EBSCOhost databases from 1 January 1987 to 30 May 2025. The methodological quality of the studies was assessed using the Newcastle–Ottawa scale. Data were analyzed using a meta-analysis web tool and reported as the mean difference (MD) and 95% confidence intervals (CIs). Twenty-seven studies, which included 3250 PLHIV on ART and 1542 who were ART-naive, were relevant. The mean age was 41.26 in ART and 39.91 years. The results showed a higher CIMT in PLHIV on ART compared to the ART-naive group, MD = 0.03 mm, 95% CI (0.02 mm to 0.04 mm), <i>p</i> < 0.0001; I<sup>2</sup> = 96.9%. Subgroup analysis showed that the inclusion of studies conducted on male participants only, those with a sample size of one hundred, and those with a moderate risk of bias contributed to heterogeneity. The results suggest there is an increased risk of atherosclerosis in PLHIV on ART.
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spelling doaj-art-53cfbef888e84fd8a795fdefd517b4e42025-08-20T03:13:58ZengMDPI AGViruses1999-49152025-06-0117789410.3390/v17070894The Association Between HIV Infection and Carotid Intima-Media Thickness in the Era of Antiretroviral Therapy: A Meta-AnalysisAngelina Nieuwoudt0Kay-Lee E. Strauss1Wendy N. Phoswa2Kabelo Mokgalaboni3Department of Life and Consumer Sciences, College of Agriculture and Environmental Sciences, University of South Africa, Roodepoort 1710, South AfricaDepartment of Life and Consumer Sciences, College of Agriculture and Environmental Sciences, University of South Africa, Roodepoort 1710, South AfricaDepartment of Life and Consumer Sciences, College of Agriculture and Environmental Sciences, University of South Africa, Roodepoort 1710, South AfricaDepartment of Life and Consumer Sciences, College of Agriculture and Environmental Sciences, University of South Africa, Roodepoort 1710, South AfricaAtherosclerosis remains a leading cause of mortality globally, and this is worse in people living with HIV (PLHIV). While the administration of antiretroviral therapy (ART) in this population has significant benefits, it is essential to acknowledge that it also has some undesired effects. This study investigated the impact of ART on carotid intima-media thickness (CIMT) in PLHIV as a marker of early atherosclerosis. A literature search was conducted on the PubMed, Scopus, and EBSCOhost databases from 1 January 1987 to 30 May 2025. The methodological quality of the studies was assessed using the Newcastle–Ottawa scale. Data were analyzed using a meta-analysis web tool and reported as the mean difference (MD) and 95% confidence intervals (CIs). Twenty-seven studies, which included 3250 PLHIV on ART and 1542 who were ART-naive, were relevant. The mean age was 41.26 in ART and 39.91 years. The results showed a higher CIMT in PLHIV on ART compared to the ART-naive group, MD = 0.03 mm, 95% CI (0.02 mm to 0.04 mm), <i>p</i> < 0.0001; I<sup>2</sup> = 96.9%. Subgroup analysis showed that the inclusion of studies conducted on male participants only, those with a sample size of one hundred, and those with a moderate risk of bias contributed to heterogeneity. The results suggest there is an increased risk of atherosclerosis in PLHIV on ART.https://www.mdpi.com/1999-4915/17/7/894antiretroviral therapyatherosclerosiscarotid intima-media thicknesscardiovascular riskhuman immunodeficiency virus
spellingShingle Angelina Nieuwoudt
Kay-Lee E. Strauss
Wendy N. Phoswa
Kabelo Mokgalaboni
The Association Between HIV Infection and Carotid Intima-Media Thickness in the Era of Antiretroviral Therapy: A Meta-Analysis
Viruses
antiretroviral therapy
atherosclerosis
carotid intima-media thickness
cardiovascular risk
human immunodeficiency virus
title The Association Between HIV Infection and Carotid Intima-Media Thickness in the Era of Antiretroviral Therapy: A Meta-Analysis
title_full The Association Between HIV Infection and Carotid Intima-Media Thickness in the Era of Antiretroviral Therapy: A Meta-Analysis
title_fullStr The Association Between HIV Infection and Carotid Intima-Media Thickness in the Era of Antiretroviral Therapy: A Meta-Analysis
title_full_unstemmed The Association Between HIV Infection and Carotid Intima-Media Thickness in the Era of Antiretroviral Therapy: A Meta-Analysis
title_short The Association Between HIV Infection and Carotid Intima-Media Thickness in the Era of Antiretroviral Therapy: A Meta-Analysis
title_sort association between hiv infection and carotid intima media thickness in the era of antiretroviral therapy a meta analysis
topic antiretroviral therapy
atherosclerosis
carotid intima-media thickness
cardiovascular risk
human immunodeficiency virus
url https://www.mdpi.com/1999-4915/17/7/894
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