Infection duration and inflammatory imbalance are associated with atherosclerotic risk in HIV-infected never-smokers independent of antiretroviral therapy

Moïse Desvarieux, Franck Boccara, Jean Luc Meynard, Jean Phillipe Bastard, Ziad Mallat, Beny Charbit, Ryan T. Demmer, Nabila Haddour, Soraya Fellahi, Alain Tedgui, Ariel Cohen, Jacqueline Capeau, Anders Boyd, Pierre Marie Girard

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23 Scopus citations

Abstract

OBJECTIVES: To determine whether the reported increased atherosclerotic risk among HIV-infected individuals is related to antiretroviral therapy (ART) or HIV infection, whether this risk persists in never-smokers, and whether inflammatory profiles are associated with higher risk. DESIGN: Matched cross-sectional study. METHODS: A total of 100 HIV-infected patients (50 ART-treated >4 years, 50 ART-naive but HIV-infected >2 years) and 50 HIV-negative controls were recruited in age-matched never-smoking male triads (mean age 40.2 years). Carotid intima-media maximal thickness (c-IMT) was measured across 12 sites. Pro-inflammatory [highly sensitive C-reactive protein (hs-CRP), resistin, interleukin-6, interleukin-18, insulin, serum amyloid A, D-dimer) and anti-inflammatory (total and high molecular weight adiponectin, interleukin-27, interleukin-10) markers were dichotomized into high/low scores (based on median values). c-IMT was compared across HIV/treatment groups or inflammatory profiles using linear regression models adjusted for age, diabetes, hypertension, and, for HIV-infected patients, nadir CD4 cell counts. RESULTS: Although adjusted c-IMT initially tended to be thicker in ART-exposed patients (P = 0.2), in post-hoc analyses stratifying by median HIV duration we observed significantly higher adjusted c-IMT in patients with longer (>7.9 years: 0.760 ± 0.008 mm) versus shorter prevalent duration of known HIV infection (<7.9 years: 0.731 ± 0.008 mm, P = 0.02), which remained significant after additionally adjusting for ART (P = 0.04). Individuals with low anti-inflammatory profile (<median versus >median score) had thicker c-IMT (0.754 ± 0.006 mm versus 0.722 ± 0.006 mm, P < 0.001), with anti-inflammatory markers declining as prevalent duration of HIV infection increased (P for linear trend <0.001). CONCLUSION: Known HIV duration is related to thicker c-IMT, irrespective of ART, in these carefully selected age-matched never-smoking HIV-treated and ART-naive male individuals. Higher levels of anti-inflammatory markers appeared protective for atherosclerosis.

Original languageEnglish (US)
Pages (from-to)2603-2614
Number of pages12
JournalAIDS
Volume27
Issue number16
DOIs
StatePublished - Oct 23 2013

Keywords

  • HIV
  • antiretroviral
  • carotid intima-media thickness
  • infection duration
  • inflammatory imbalance
  • smoking

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    Desvarieux, M., Boccara, F., Meynard, J. L., Bastard, J. P., Mallat, Z., Charbit, B., Demmer, R. T., Haddour, N., Fellahi, S., Tedgui, A., Cohen, A., Capeau, J., Boyd, A., & Girard, P. M. (2013). Infection duration and inflammatory imbalance are associated with atherosclerotic risk in HIV-infected never-smokers independent of antiretroviral therapy. AIDS, 27(16), 2603-2614. https://doi.org/10.1097/QAD.0b013e3283634819