Retinal vascular calibres in older HIV-positive men compared to HIV-negative and younger HIV+ controls

Abstract

Purpose : Life expectancy of HIV seropositive people (HIV+) now approaches that of the general population, but HIV infection is thought to be associated with increased risk of cerebrovascular disease (CSVD). This study aimed to determine if such association between HIV status and retinal vascular measurements can be quantified.

Methods : A subset of white, male participants was recruited into this ophthalmic substudy from the POPPY multicentre cohort study, comprising three demographically matched groups (HIV+ aged >50 years (OHIV+); HIV-neg >50 (OHIV-); HIV+ <50 (YHIV+)). Participants with diabetes and those not receiving effective antiretroviral therapy were excluded. Optic disc centred 45 degree colour fundus photographs were taken and used to calculate central retinal arterial (CRAE) and venular (CRVE) calibre and the arteriolar/venular ratio (AVR). Retinal measurements from one randomly-chosen eye per participant were compared between groups using ANOVA. The association between HIV status and AVR was estimated in a multivariable linear regression model adjusted for age and factors associated with AVR on bivariate models (p<0.2).

Results : Included were 120 OHIV+ (median age 59 y; interquartile range [IQR] 54, 65), 52 OHIV- (median age 60; IQR 55, 65) and 39 YHIV+ (median age 44; IQR 41, 48). Ten-year risk of cardiovascular disease (Framingham model) was 7.4% in OHIV+, 7.6% in OHIV- and 2.8% in YHIV+. There were no significant differences in blood pressure (BP), body mass index, lipids; smoking and recreational use of stimulants were non-significantly more prevalent in YHIV+ (p<0.15). Seven OHIV+ (5.8%) had a history of stroke compared to none of the other groups (p=0.07). Mean (SD) of the retinal measures were CRAE 142.0 (20.2), CRVE 199.0 (29.1) and AVR 0.72 (0.06) in the OHIV+; CRAE 138.6 (20.4), CRVE 193.4 (26.1) and AVR 0.72 (0.07) in the OHIV-; CRAE 142.9 (20.3), CRVE 195.6 (27.7) and AVR 0.74 (0.09) in the YHIV+, with no differences between groups (p>0.1 for all comparisons). In a multivariable model incorporating age, recreational use of stimulants, stroke history, syphilis history and systolic BP, HIV status was not associated with AVR (β=0.003, 95% confidence interval [CI] -0.02, 0.03, p=0.77).

Conclusions : We found no definite difference in retinal vascular indices signifying increased CSVD risk between white OHIV+ men and OHIV- or YHIV+ controls in our well-controlled cohort.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.