Among adolescents with HIV in Tanzania, higher arterial stiffness was independently associated with shorter sleep duration, prolonged sleep latency ≥15 min, and current use of a protease inhibitor antiretroviral regimen.
9.6% of adolescents with HIV in Tanzania had arterial stiffness defined as carotid-femoral pulse wave velocity at or above the 90th percentile.
The mean carotid-femoral pulse wave velocity in Tanzanian adolescents with HIV was lower than estimates reported in high-income country cohorts and comparable to some sub-Saharan African cohorts.
Shorter sleep duration was independently associated with higher carotid-femoral pulse wave velocity in adolescents with HIV.
Prolonged sleep latency of 15 minutes or more was independently associated with higher carotid-femoral pulse wave velocity.
Current use of a protease inhibitor antiretroviral regimen was independently associated with higher carotid-femoral pulse wave velocity.
This research examined hardening of the arteries (arterial stiffness) — an early warning sign of heart disease — in 416 teenagers living with HIV in Tanzania. The researchers measured how fast a pulse wave travels through a major artery, which reflects how stiff or flexible blood vessels are. They found that about 1 in 10 of these adolescents had arterial stiffness measurements above what is considered a concerning threshold, and that the average stiffness levels were lower than those reported for HIV-positive teenagers in wealthier countries but similar to some other African studies. Importantly, the study found that poor sleep behaviors were linked to stiffer arteries. Teenagers who slept fewer hours per night and those who took longer than 15 minutes to fall asleep had measurably stiffer arteries, even after accounting for other known risk factors like age, weight, and blood pressure. Additionally, teenagers who were taking a specific class of HIV medications called protease inhibitors had higher arterial stiffness compared to those on other HIV drug regimens. This research suggests that sleep quality and duration — factors not traditionally emphasized in HIV care for adolescents — may play a meaningful role in cardiovascular health in this population. It also adds to existing concerns about protease inhibitor-based HIV treatments and heart health. The authors suggest that screening for arterial stiffness early, particularly among HIV-positive adolescents with poor sleep habits or those on protease inhibitor regimens, could help identify those at risk and prompt interventions like lifestyle changes before more serious cardiovascular problems develop.
Masoza T, Andy C, Willkens M, Kibona S, Bundschuh E, Peck R, et al.. (2026). Subclinical cardiovascular risk among adolescents with HIV in Tanzania: the role of sleep behaviour and antiretroviral regimen on arterial stiffness.. HIV research & clinical practice. https://doi.org/10.1080/25787489.2026.2725472