Objective: Although opportunistic infections and malignancies have declined due to antiretroviral therapy, the prevalence of cardiovascular disease (CVD) among people with human immunodeficiency virus (PWH) has increased. This study examines early markers of CVD using transthoracic echocardiography (TTE) performed at rest and after a 6-minute walk test (6-MWT) in PWH. This prospective study was conducted in Türkiye between 2019 and 2022.

Methods: The PWH and healthy individuals were evaluated for demographic and laboratory analysis and examined using TTE at rest and after 6-MWT.

Results: The interventricular septum (IVS) and posterior wall (PW) were significantly thicker in the PWH group than in healthy controls. Pulmonary pulse transit time (pPTT)
was markedly reduced in PWH (127.5 ms vs. 457 ms, P < .001). In the PWH group, the E/e’ ratio increased after 6-MWT [6.26 (IQR: 5.1-7.3) vs. 5.9 (IQR: 4.9-6.9) at rest (P = .028)]. The PWH with CD4+ counts <350/mm3 exhibited a higher E/e’ ratio [6.91 (IQR: 5.05-8.62)] than those with CD4+ counts >350/mm3 [5.41 (IQR: 4.87-6.17); P = .035]. A weak inverse correlation was observed between CD4+ count and E/e’ ratio (P = .010, r = −0.348).

Conclusions: The IVS thickness, PW thickness, E/e’ ratio, and pPTT may serve as valuable parameters for the early detection of CVD in PWH. Changes in diastolic indices may offer insights into disease progression. The pPTT may be a promising marker for evaluating the pulmonary vascular status and right ventricular function. These findings underscore the need for further research into the diagnostic and prognostic utility of diastolic parameters and pPTT in the clinical management of PWH.