Retinal Vessel Functional Responses in South Africans Living With and Without HIV: The EndoAfrica-NWU Study

Abstract

Objectives: The effects of HIV and antiretroviral therapy (ART) on microvascular function are poorly explored. We compared retinal vessel functional responses to flicker light- induced provocation (FLIP) in people living with HIV (PLWH) and people living without HIV (PLWoutH). Methods: We included 115 PLWH and 51 PLWoutH with a median age of 41 years. Treated PLWH received similar first- line fixed- dose combination ART. Clinical characteristics and retinal vessels functional responses to FLIP were compared in (a) PLWH and PLWoutH; and (b) PLWH groups stratified by the median of (i) CD4- count (511 cells/mm3), (ii) viral load (50 copies/mL), and (iii) ART duration (57.6 months). Results: PLWH were older, smoked more, and had a lower prevalence of hypertension than PLWoutH (p < 0.05). Almost 64% of PLWH were infected for more than 5 years. Retinal vessel responses to FLIP were similar between PLWH and PLWoutH after taking confounders into account. In addition, PLWH subgroups stratified according to immuno- virological status by CD4- count, viral load, and ART duration showed no differences in retinal vessel responses to FLIP. Conclusion: Living with HIV and receiving ART were not associated with altered microvascular function as assessed with dynamic retinal vessel analysis in a South African case-control study.