Abstract

Patients successfully treated for HIV infection still have an increased risk for cardiovascular morbidity and mortality, which might be related not only to traditional risks, but also to inflammation and dyslipidemia. We examined the relationship of serum lipid levels with plasma biomarkers of inflammation using a composite inflammatory burden score (IBS) based on individual (>75th percentile) measurements from the following seven markers: CD40L, tPA, MCP-1, IL-8, IL-6, hCRP and P-selectin. IBS was categorized as 0 (none of the biomarkers >75th percentile), 1, 2 and 3 or more scores. Correlations between the IBS and lipid parameters were examined by ordered logistic regression proportional odds models to estimate the odds of more elevated biomarkers. 181 male patients with undetectable HIV-viremia were included into the study. In the multivariate model, a one-unit increase (mmol/L) of total cholesterol and triglycerides was associated with a 1.41-fold (95% CI, 1.13–1.76) and 1.37-fold (95% CI, 1.18–1.60) increased odds of having a greater IBS, respectively. Those with an IBS score ≥1 compared to none had 2.14 (95% CI, 1.43–3.20) higher odds of having a one-unit increased total cholesterol/HDL-cholesterol ratio. In successfully treated HIV-infected persons dyslipidemia was associated with inflammation.

Highlights

  • Cardiovascular diseases are important causes of morbidity and mortality in persons infected with human immunodeficiency virus type 1 (HIV-1)[1,2,3]

  • The aim of this study was to analyze the possible association between serum lipid levels and plasma biomarkers of inflammation using a composite inflammatory burden score (IBS) from the following seven markers of inflammation: CD40L, tPA, monocyte chemoattractant protein-1 (MCP-1), IL-8, IL-6, hCRP and P-selectin in successfully treated HIV-infected patients

  • The patients were mainly treated with two nucleoside reverse transcriptase inhibitors (NRTI) plus one non-NRTI (NNRTI) (n = 100, 60.8%) or two NRTI plus lopinavir (N = 50, 27.6%)

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Summary

Introduction

Cardiovascular diseases are important causes of morbidity and mortality in persons infected with human immunodeficiency virus type 1 (HIV-1)[1,2,3]. Persistent immune activation and systemic inflammation, plays a central role in the pathogenesis of HIV-disease, and contributes to the increased risk of CAD in both untreated and successfully-treated patients. Vos et al.[9] performed a systematic literature review on the associations between inflammatory biomarkers and CVD or CIMT in HIV-infected persons that included 33 original datasets and analysis of 48 immune markers. Markers of inflammation, endothelial activation or coagulation as well as other biological response modifiers including growth factors and chemokines with CIMT9 Since these results are, in part, related to the heterogeneity of study design and selection of biomarkers, further research on the association between CVD and inflammatory biomarkers, in the context of antiretroviral therapy, are needed

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