TY - JOUR
T1 - Infection duration and inflammatory imbalance are associated with atherosclerotic risk in HIV-infected never-smokers independent of antiretroviral therapy
AU - Desvarieux, Moïse
AU - Boccara, Franck
AU - Meynard, Jean-Luc
AU - Bastard, Jean-Phillipe
AU - Mallat, Ziad
AU - Charbit, Beny
AU - Demmer, Ryan T.
AU - Haddour, Nabila
AU - Fellahi, Soraya
AU - Tedgui, Alain
AU - Cohen, Ariel
AU - Capeau, Jacqueline
AU - Boyd, Anders
AU - Girard, Pierre-Marie
PY - 2013/10/23
Y1 - 2013/10/23
N2 - OBJECTIVES: To determine whether the reported increased atherosclerotic risk among HIV-infected individuals is related to antiretroviral therapy (ART) or HIV infection, whether this risk persists in never-smokers, and whether inflammatory profiles are associated with higher risk. DESIGN: Matched cross-sectional study. METHODS: A total of 100 HIV-infected patients (50 ART-treated >4 years, 50 ART-naive but HIV-infected >2 years) and 50 HIV-negative controls were recruited in age-matched never-smoking male triads (mean age 40.2 years). Carotid intima-media maximal thickness (c-IMT) was measured across 12 sites. Pro-inflammatory [highly sensitive C-reactive protein (hs-CRP), resistin, interleukin-6, interleukin-18, insulin, serum amyloid A, D-dimer) and anti-inflammatory (total and high molecular weight adiponectin, interleukin-27, interleukin-10) markers were dichotomized into high/low scores (based on median values). c-IMT was compared across HIV/treatment groups or inflammatory profiles using linear regression models adjusted for age, diabetes, hypertension, and, for HIV-infected patients, nadir CD4 cell counts. RESULTS: Although adjusted c-IMT initially tended to be thicker in ART-exposed patients (P = 0.2), in post-hoc analyses stratifying by median HIV duration we observed significantly higher adjusted c-IMT in patients with longer (>7.9 years: 0.760 ± 0.008 mm) versus shorter prevalent duration of known HIV infection (<7.9 years: 0.731 ± 0.008 mm, P = 0.02), which remained significant after additionally adjusting for ART (P = 0.04). Individuals with low anti-inflammatory profile (median score) had thicker c-IMT (0.754 ± 0.006 mm versus 0.722 ± 0.006 mm, P < 0.001), with anti-inflammatory markers declining as prevalent duration of HIV infection increased (P for linear trend <0.001). CONCLUSION: Known HIV duration is related to thicker c-IMT, irrespective of ART, in these carefully selected age-matched never-smoking HIV-treated and ART-naive male individuals. Higher levels of anti-inflammatory markers appeared protective for atherosclerosis. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.
AB - OBJECTIVES: To determine whether the reported increased atherosclerotic risk among HIV-infected individuals is related to antiretroviral therapy (ART) or HIV infection, whether this risk persists in never-smokers, and whether inflammatory profiles are associated with higher risk. DESIGN: Matched cross-sectional study. METHODS: A total of 100 HIV-infected patients (50 ART-treated >4 years, 50 ART-naive but HIV-infected >2 years) and 50 HIV-negative controls were recruited in age-matched never-smoking male triads (mean age 40.2 years). Carotid intima-media maximal thickness (c-IMT) was measured across 12 sites. Pro-inflammatory [highly sensitive C-reactive protein (hs-CRP), resistin, interleukin-6, interleukin-18, insulin, serum amyloid A, D-dimer) and anti-inflammatory (total and high molecular weight adiponectin, interleukin-27, interleukin-10) markers were dichotomized into high/low scores (based on median values). c-IMT was compared across HIV/treatment groups or inflammatory profiles using linear regression models adjusted for age, diabetes, hypertension, and, for HIV-infected patients, nadir CD4 cell counts. RESULTS: Although adjusted c-IMT initially tended to be thicker in ART-exposed patients (P = 0.2), in post-hoc analyses stratifying by median HIV duration we observed significantly higher adjusted c-IMT in patients with longer (>7.9 years: 0.760 ± 0.008 mm) versus shorter prevalent duration of known HIV infection (<7.9 years: 0.731 ± 0.008 mm, P = 0.02), which remained significant after additionally adjusting for ART (P = 0.04). Individuals with low anti-inflammatory profile (median score) had thicker c-IMT (0.754 ± 0.006 mm versus 0.722 ± 0.006 mm, P < 0.001), with anti-inflammatory markers declining as prevalent duration of HIV infection increased (P for linear trend <0.001). CONCLUSION: Known HIV duration is related to thicker c-IMT, irrespective of ART, in these carefully selected age-matched never-smoking HIV-treated and ART-naive male individuals. Higher levels of anti-inflammatory markers appeared protective for atherosclerosis. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.
KW - Adult
KW - Antiretroviral Therapy, Highly Active/methods
KW - Atherosclerosis/epidemiology
KW - C-Reactive Protein/analysis
KW - Carotid Intima-Media Thickness
KW - Cross-Sectional Studies
KW - HIV Infections/complications
KW - Humans
KW - Intercellular Signaling Peptides and Proteins/blood
KW - Male
KW - Risk Factors
KW - Time Factors
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84885405993&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/24100713
U2 - https://doi.org/10.1097/QAD.0b013e3283634819
DO - https://doi.org/10.1097/QAD.0b013e3283634819
M3 - Article
C2 - 24100713
SN - 0269-9370
VL - 27
SP - 2603
EP - 2614
JO - AIDS (London, England)
JF - AIDS (London, England)
IS - 16
ER -