Abstract P261: HIV-positive Individuals With Undetectable Viral Loads Have suPAR Levels Comparable to HIV-negative Individuals

Abstract

Introduction: Individuals with poorly-controlled HIV have high levels of plasma soluble urokinase plasminogen activator receptor (suPAR), a marker of immune activation associated with all-cause mortality, incident myocardial infarction and HIV-associated nephropathy in HIV-positive individuals. Data is conflicting regarding the effect of viral suppression on suPAR levels in HIV-positive individuals, or how these levels compare to individuals without HIV. Hypothesis: HIV-positive individuals with undetectable viral loads (VLs) will have similar levels of suPAR compared to individuals without HIV. Methods: Plasma suPAR was measured by ELISA in 273HIV-positive (70% Black [n=167], age 42 ± 8 years, 86% female [n=240], 56% detectable viral load [n=150]) and 276 HIV-negative (63% Black [n=169], age 40 ± 9 years, 96% female [n=265]) outpatients. Demographics, medical history and laboratory samples were collected. Results: Compared to HIV-negative individuals, HIV-positive subjects were older (p=0.01), less likely to be female (p<0.001), had lower body mass index (28 ± 7 vs. 30 ± 8 kg/m 2 , p<0.001) and worse renal function (eGFR 92 ± 19 vs. 97 ± 20 mL/min/1.73 m 2 , p=0.004). Median suPAR level was similar for HIV-negative and HIV-positive subjects with undetectable VLs (2436 [1908, 3380] vs. 2667 [1966, 4034] pg/mL, p=0.256), and both were significantly lower compared to HIV-positive subjects with detectable VLs (4252 [3099, 5369] pg/mL, p<0.001). Within HIV-positive subjects, a detectable viral load was an independent predictor for high suPAR (OR 2.37 [95% CI 1.07-5.25], p=0.03) after controlling for age, race, sex, body mass, smoking history, hypertension, diabetes, eGFR and CD4+ count. Conclusions: In conclusion,HIV-positive individuals with undetectable VLs have similar levels of suPAR compared to those without HIV. Lower suPAR levels may account for the lower incidence of cardiovascular events and HIV nephropathy in patients with well-controlled HIV.