Myocardial extracellular volume fraction is positively associated with activated monocyte subsets among cART-treated persons living with HIV in South Africa

Tess E. Peterson, Muki Shey, Nomawethu Masina, Lye Yeng Wong, Scott R. Shuldiner, Julian Wolfson, Stephen Jermy, Hadil Saad, Mbalabu A.J. Lumbamba, Achita Singh, Graeme Meintjes, Ntobeko A.B. Ntusi, Mpiko Ntsekhe, Jason V. Baker

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Abstract

Background: Despite treatment with combination antiretroviral therapy (cART), persons living with HIV (PLWH) are at higher risk of cardiac structural abnormalities that may presage clinical heart failure, including myocardial fibrosis. This study assessed whether circulating cellular and soluble protein markers of immune activation cross-sectionally associate with myocardial fibrosis among cART-treated PLWH in South Africa. Methods: Participants were enrolled in Khayelitsha township near Cape Town, SA. Cardiac magnetic resonance imaging was performed. Plasma protein biomarkers were measured using enzyme-linked immunoassays and monocyte phenotypes were evaluated using flow cytometry. Associations were assessed using multivariable linear and logistic regression. Results: Among 69 cART-treated PLWH, mean (SD) age was 48 (10) years, 71% were female, and time since HIV diagnosis was 9 (6) years. Evidence of left ventricular fibrosis by late gadolinium enhancement was present in 74% of participants and mean (SD) extracellular volume fraction (ECV) was 30.9 (5.9)%. Degree of myocardial fibrosis/inflammation measured by ECV was positively associated with percentages of circulating non-classical and intermediate monocyte phenotypes reflecting inflammation and tissue injury. Conclusion: These data generate hypotheses on possible immune mechanisms of HIV-associated non-ischemic myocardial disease, specifically among cART-treated PLWH in sub-Saharan Africa, where the majority of the HIV burden exists globally.

Original languageEnglish (US)
Article number131332
JournalInternational Journal of Cardiology
Volume392
DOIs
StatePublished - Dec 1 2023

Bibliographical note

Publisher Copyright:
© 2023 Elsevier B.V.

Keywords

  • Extracellular volume fraction
  • HIV infection
  • Monocyte activation
  • Monocyte phenotype
  • Myocardial fibrosis

PubMed: MeSH publication types

  • Journal Article

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