Pulse waveform analysis in Zambian adults living with <scp>HIV</scp> on antiretroviral therapy: A cross‐sectional study of vascular dysfunction

Abstract

People living with HIV (PLWH) experience a greater risk of cardiovascular disease due to HIV-related vascular injury. Pulse waveform analysis can characterize arterial vascular dysfunction and this study compared arterial waveforms in PLWH on antiretroviral therapy (ART) with HIV-negative controls. In this cross-sectional study, participants were recruited from the University Teaching Hospitals, Lusaka (September 2018-June 2019). 55 PLWH on ART ≥2 years and 56 HIV-negative controls were recruited. Anthropometry, body composition, haemodynamics, and pressure waveforms were recorded using the Complior Analyze unit with their corresponding pulse wave velocities. Waveforms were classified by augmentation-index/pulse-pressure ratio as Types A (≥0.12), B (0-0.12), or C (<0). Appropriate parametric and nonparametric tests were used for analysis. Analysis of 111 waveforms showed Type-A predominance in PLWH (80% A, 3.6% B, 16.6% C) and HIV-negative controls (57% A, 8.9% B, 33.9% C). Fisher's Exact Test indicated an association between waveform type and HIV status (p = 0.037). Multinomial logistic regression revealed that PLWH were more likely to exhibit Type-A waveform than Type-B or C (Wald χ²(2) = 48.17, p < 0.001). HIV status is associated with a shift toward Type-A waveform, reflecting altered arterial function. Pulse waveform analysis may serve as a useful non-invasive tool for vascular risk profiling in PLWH.