High-sensitivity C-reactive protein levels in HIV-infected patients treated or not with antiretroviral drugs and their correlation with factors related to cardiovascular risk and HIV infection

Abstract

Aims To compare high-sensitivity C-reactive protein (hsCRP) in HIV-infected patients treated or not with antiretroviral (ARV) drugs and to correlate hsCRP levels with traditional cardiovascular risk factors and parameters of HIV infection. Methods One hundred and seventy-one HIV-infected patients were included (129 ARV-treated and 42 ARV-naïve). Evaluations included anthropometric measurements, blood pressure, laboratory tests, ultrasonographic measurement of fat thickness and impedance analysis. Results hsCRP levels were higher in ARV-treated compared to ARV-naïve patients ( p < 0.001). Seventy-two (56%) ARV-treated patients and 11 (26%) ARV-naïve patients had hsCRP concentrations >3 mg/dl (high risk for cardiovascular complications) (OR 3.56; 95%CI: 1.55–8.29; p = 0.001, χ 2 test). hsCRP levels correlated positively with waist measurement ( p = 0.004), waist-to-hip ratio ( p < 0.001), systolic ( p = 0.05) and diastolic ( p = 0.03) blood pressure, intra-abdominal fat thickness ( p = 0.02), triglycerides ( p = 0.001), total cholesterol ( p = 0.01), fasting glucose ( p = 0.01), and glucose ( p < 0.001) and insulin levels ( p = 0.02) measured 2 h after load. No correlation was found between hsCRP levels and CD4 cell counts and HIV-viral load. Independent factors associated with hsCRP levels were therapy with current non-nucleoside reverse transcriptase inhibitors (NNRTI) ( p = 0.003), waist-to-hip ratio ( p = 0.006), fasting glucose ( p = 0.049) and glucose levels 2 h after load ( p = 0.003) in multivariate analysis model 1 and current NNRTI therapy ( p < 0.001), protease inhibitor therapy ( p = 0.016) and cardiometabolic syndrome ( p = 0.022) in multivariate analysis model 2. Conclusion hsCRP in HIV-infected patients is associated with traditional cardiovascular risk factors, principally in ARV-treated patients. hsCRP levels are not associated with CD4 cell counts and HIV-viral load and may constitute a marker for cardiovascular risk related to HIV infection and ARV therapy.