Mechanisms of Diastolic Dysfunction Among Persons With HIV Compared With Non-HIV Control Subjects

HIV positive subjects

Inclusion criteria

• age ≥40 and ≤75 years
• documented HIV infection
• participant report that combination antiretroviral therapy (cART) (any regimen) has been taken stably without > 4 week interruption for at least 180 days prior to study entry (report of switching regimens in that time frame is permissible)

Exclusion criteria

• CD4 < 100 cell/mm3
• current active AIDS-defining illness
• current active or recent (not fully resolved within 30 days prior to study entry) systemic bacterial, fungal, parasitic, or viral infections (except HIV, HBV, human papillomavirus [HPV], or HCV)
• current active cancer
• clinical ASCVD, as defined by 2013 ACC/AHA guidelines (including previous diagnosis of AMI, ACS, stable or unstable angina, coronary or other arterial revascularization, stroke, TIA, PAD), by subject report
• clinical diagnosis of HFpEF or HFrEF, by subject report
• diagnosed DM on antihyperglycemic medication
• current, active use of immune suppressant medication including oral or intravenous corticosteroid or injectable biologic (oral ASA or NSAID use permitted)
• eGFR <45 ml/min/1.73 m2 calculated by CDK-EPI
• standard contraindications to MRI procedure based on MGH MRI Patient Procedure Screening Form - including history of severe allergy to gadolinium
• use of lipid lowering agents including statin drugs, fibrates, ezetimibe, red yeast rice, niacin or omega-3 fatty acids (>3 grams/day in standalone formulations) in the 90 days prior to study entry
• use of ACE inhibitor, ARB, or aldosterone receptor blocker in the 90 days prior to study entry
• pregnancy or breastfeeding (female subjects of reproductive potential)
• other medical, psychiatric, or psychological condition that, in the opinion of the study investigator, would interfere with completion of study procedures

HIV negative subjects:

Inclusion criteria

• age ≥40 and ≤75 years

Exclusion criteria

• HIV infection
• current active or recent (not fully resolved within 30 days prior to study entry) systemic bacterial, fungal, parasitic, or viral infections (except HIV, HBV, human papillomavirus [HPV], or HCV)
• current active cancer
• clinical ASCVD, as defined by 2013 ACC/AHA guidelines (including previous diagnosis of AMI, ACS, stable or unstable angina, coronary or other arterial revascularization, stroke, TIA, PAD), by subject report
• clinical diagnosis of HFpEF or HFrEF, by subject report
• diagnosed DM on antihyperglycemic medication
• current, active use of immune suppressant medication including oral or intravenous corticosteroid or injectable biologic (oral ASA or NSAID use permitted)
• eGFR <45 ml/min/1.73 m2 calculated by CDK-EPI
• standard contraindications to MRI procedure based on MGH MRI Patient Procedure Screening Form - including history of severe allergy to gadolinium
• use of lipid lowering agents including statin drugs, fibrates, ezetimibe, red yeast rice, niacin or omega-3 fatty acids (>3 grams/day in standalone formulations) in the 90 days prior to study entry
• use of ACE inhibitor, ARB, or aldosterone receptor blocker in the 90 days prior to study entry
• pregnancy or breastfeeding (female subjects of reproductive potential)
• other medical, psychiatric, or psychological condition that, in the opinion of the study investigator, would interfere with completion of study procedures