Abstract 12682: Markers of Microbial Translocation Biomarkers in People Living With HIV Infection and Their Relationship With Myocardial Function and Fibrosis: Myocardial and Coronary Abnormalities in HIV Infection (MACHIN) Study

Abstract

Background: Microbial translocation (MT) is suggested to play a role in increases risk of myocardial fibrosis (MF) and LV dysfunction in people living with HIV infection (PLWH). We investigated the association of biomarkers of MT with myocardial disease in MACHIN study. Methods: Biomarkers of MT (soluble CD14 (sCD14), FABP, SGP130, and BDG) were measured in serum samples of 92 participants (54 PLWH and 38 HIV- controls, mean age 47±14 years, 28% female). Myocardial structure and function were assessed using CMR. In addition, our protocol included detection of overt MF using delayed-enhancement images as well as diffuse MF using extracellular volume (ECV)-measured by T1 mapping. Results: FABP levels were significantly higher in PLWH compared to controls (percentage of people in higher tertile 17% vs 47%, respectively, OR: 4.4, 95% CI: 1.4-13.5, p: 0.01) and this association was significant after adjustment for age and race. Higher values of FABP were significantly correlated with presence and extent of MF. Participants with higher tertile of FABP had a significantly higher odds of presence of MF (ECV above median) compared to controls (OR: 5.9, 95% CI: 1.3, 27.0, p: 0.02) after adjustment for HIV status, age, gender, and race. Furthermore, participants with high FABP also had higher extent of MF (calculated ECV values) compared to controls (adjusted regression coefficient 6.7%, p<0.01). Importantly, while HIV infection was significantly associated with presence and extent of MF, these associations were not significant when FABP was added to the models, suggesting that FABP may explain the relationship between HIV infection and MF. PLWH had significantly higher levels of sCD14 compared to controls (p <0.05), even after adjustment for age, gender, and race (p-value: 0.04). However, serum levels of sCD14 was not associated with LV and RV systolic function, LV mass, MF, or delayed-enhancement on cardiac MRI. SGP130 and BDG were not significantly associated with MF. Conclusion: Increased levels of biomarkers of microbial translocation is observed in virologically-suppressed PLWH and may explain the increased risk of MF in these patients.