Association Between Left Ventricular Diastolic Dysfunction, Systemic Inflammation, and Gastrointestinal Symptoms in HIV-Positive Patients on Antiretroviral Therapy

• Published in: Diseases 2024-12, Vol.12 (12), p.313
• Main Authors: Suba, Madalina-Ianca, Hogea, Bogdan, Abu-Awwad, Ahmed, Lazureanu, Voichita Elena, Rosca, Ovidiu, Gurgus, Daniela, Laitin, Sorina Maria Denisa, Abu-Awwad, Alina
• Format: Article
• Language: English
• Subjects: Antiretroviral therapy; Antiviral agents; Biomarkers; Body mass index; Causes of; Chronic illnesses; Comorbidity; Comparative analysis; Complications and side effects; Development and progression; Diarrhea; Dosage and administration; Drug therapy; Fibrinogen; gastrointestinal complications; Heart; Heart failure; HIV; HIV infection; Human immunodeficiency virus; Infections; Infectious diseases; Inflammation; inflammatory biomarkers; Laboratories; LVDD; Patients; Population; Population studies; Risk factors; systemic inflammation; Tumor necrosis factor-α; Ventricle; γ-Interferon
• ISSN: 2079-9721; 2079-9721
• DOI: 10.3390/diseases12120313

Despite advancements in antiretroviral therapy (ART), HIV-positive individuals face heightened risks of cardiovascular and gastrointestinal (GI) complications, often linked to persistent systemic inflammation. Left ventricular diastolic dysfunction (LVDD), prevalent in HIV patients, exacerbates this inflammatory state and may contribute to worsened GI symptoms. This study aims to explore the association between LVDD, systemic inflammation, and gastrointestinal symptoms in HIV-positive patients undergoing ART. The primary objective is to analyze how LVDD contributes to the inflammatory burden and its impact on gastrointestinal health in this population. This cross-sectional study included 320 participants divided into three groups: HIV-positive with LVDD (n = 80), HIV-positive without LVDD (n = 120), and HIV-negative controls (n = 120). Levels of inflammatory biomarkers-CRP, IL-6, TNF-α, fibrinogen, IL-1β, IFN-γ, and D-dimer-were measured, and GI symptoms were assessed. Echocardiographic evaluations were performed to determine LVDD presence and severity, while multivariate logistic regression identified predictors of GI complications. Patients in the HIV + LVDD group exhibited significantly elevated levels of TNF-α, CRP, and D-dimer compared to other groups, correlating with higher incidences of nausea, diarrhea, and abdominal pain. TNF-α emerged as the strongest predictor of GI symptoms, underscoring its role in the pathophysiology linking cardiovascular and GI distress in this population. Persistent inflammation and coagulation abnormalities in the ART + LVDD group suggest that ART alone may not fully mitigate these complications. Our findings emphasize the compounded inflammatory burden in HIV patients with LVDD, highlighting the need for integrated approaches that address both cardiovascular and GI symptoms. Anti-inflammatory therapies targeting specific biomarkers like TNF-α could improve clinical outcomes, supporting a more comprehensive strategy to managing HIV-related comorbidities beyond viral suppression.