Angiopoietin-2 and endothelial damage associated with viral load in untreated people living with HIV

BackgroundHIV infection is associated with various types of endothelial damage. Early and accurate diagnosis of endothelial dysfunction may help prevent adverse outcomes. For the first time, this cross-sectional study aims to investigate the effects of increased viral load on endothelial damage and nephrinuria in untreated people living with HIV.MethodsPeople living with HIV not on treatment were included. Laboratory parameters, such as viral load and CD4 count were collected. Participants were divided into three groups according to the tertiles of viral load: low, moderate and high viral load groups. Urinary nephrin, vascular cell adhesion molecule 1 (VCAM-1), angiopoietin-2 and syndecan-1 were quantified by sandwich ELISA assays kits.ResultsA total of 49 patients were examined. The high viral load group (3rd tertile) exhibited a greater frequency of nephrinuria and significantly higher levels of syndecan-1 (58 [48-93] vs 43 [38-65] ng/mL, <i>p</i> = .049) and angiopoietin-2 (2.58 [1.5-3.06] vs 1.34 [0.89-1.76] ng/mL, <i>p</i> = .035). Syndecan-1 levels positively correlated with viral load (rho = 0.452, <i>p</i> = .006), while angiopoietin-2 was positively correlated with viral load (rho = 0.529, <i>p</i> = .001) and inversely correlated with CD4 count (rho = -0.493, <i>p</i> = .003). No significant associations were found for VCAM-1 levels.ConclusionUntreated people living with HIV with elevated viral loads exhibited more pronounced endothelial damage and vascular inflammation, emphasizing the critical importance of early initiation of antiretroviral treatment to mitigate these complications. However, the study's findings should be interpreted with caution due to the small sample size, which may limit the generalizability of the results. Future studies with larger cohorts are needed to confirm these findings.