Hemorheology in asymptomatic HIV-infected patients

Although cardiac and vascular complications have been recognized among pati ents infected with the Human Immunodeficiency Virus-1 (HIV-1), their vascul ar biology and rheology have not been studied. Rheology of red blood cells (RBC) was assessed with an erythroaggregometer in 22 HIV-1 infected asympto matic patients (pts) and 17 healthy HIV negative controls (C). All particip ants were normotensive, nondiabetics, had normal lipid levels and had an he matocrit ranging from 37 to 44% and hemoglobin levels greater than or equal to 12 g/100 ml. Patients had a shorter RBC aggregation characteristic time than controls (1.49 +/- 0.17 vs. 2.04 +/- 0.41 s, p = 0.001) and an increa sed disaggregation shear rate (166 +/- 34.9 vs. 122 +/- 25.4 s(-1) p = 0.00 1). This hyperaggregation tendancy was associated with increased gamma -glo bulin (18.3 +/- 3.3 vs. 13.7 +/- 1.9 g/l, p = 0.01) and fibrinogen (3.52 +/ - 0.57 vs 3.03 +/- 0.48 g/l, p = 0.003) levels and with an increased erythr ocyte sedimentation rate (ESR) (25 +/- 14.3 vs. 12.3 +/- 7.5 mm, p = 0.02). Even in patients with ESRs ranging within normal values (less than or equa l to 20 mm), the aggregation characteristic time was found lower in patient s than in controls (p = 0.004). There was no correlation between these rheo logical changes and the CD4+ T-cell count. The 17 patients receiving an ant iviral therapy had lower CD4+ T-cell counts than their 5 untreated counterp arts (244.7 +/- 167 vs. 410 +/- 106/mm(3), p = 0.025), and a higher disaggr egation shear rate (177.4 +/- 38.2 vs. 127 +/- 25.4, p = 0.01). Thus, an im pairment of rheological characteristics is observed in asymptomatic HIV-1 i nfected patients in association with changes in plasma proteins.