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Sequencing of Bacterial Microflora in Peripheral Blood: our Experience with HIV-infected Patients
Published on: June 11, 2011
Arterial inflammation in patients with HIV
Sharath Subramanian1, Ahmed Tawakol, Tricia H Burdo
1MR-PET-CT Program and Department of Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA.
JAMA
|July 24, 2012
Summary
Patients with human immunodeficiency virus (HIV) show increased arterial inflammation, even with controlled disease and low traditional risk factors. This inflammation is linked to monocyte and macrophage activation markers.
Area of Science:
- Cardiovascular research
- Immunology
- Radiology
Background:
- Cardiovascular disease (CVD) risk is elevated in human immunodeficiency virus (HIV)-infected individuals.
- The precise mechanisms driving this increased CVD risk remain unclear.
- Monocyte and macrophage activation, indicated by soluble CD163 (sCD163), may play a role.
Purpose of the Study:
- To evaluate arterial wall inflammation in HIV patients using 18fluorine-2-deoxy-D-glucose positron emission tomography (18F-FDG-PET).
- To correlate arterial inflammation with traditional and nontraditional cardiovascular risk markers, including sCD163.
- To compare arterial inflammation in HIV patients with non-HIV control groups.
Main Methods:
- A cross-sectional study involving 81 participants (27 HIV, 54 controls) at Massachusetts General Hospital.
- Cardiac 18F-FDG-PET assessed arterial inflammation via the target-to-background ratio (TBR) in the aorta.
- Coronary computed tomography scanning evaluated coronary artery calcium; comparisons were made with age/sex/Framingham Risk Score (FRS)-matched and atherosclerotic controls.
Main Results:
- HIV participants had well-controlled HIV disease and low mean FRS, similar to FRS-matched controls.
- Aortic TBR (arterial inflammation) was significantly higher in HIV patients compared to FRS-matched controls (P < .001).
- Aortic TBR in HIV patients was associated with sCD163 levels (P = .04) but not C-reactive protein or D-dimer.
Conclusions:
- HIV-infected individuals exhibit increased arterial inflammation compared to non-infected individuals with similar cardiac risk profiles.
- This heightened inflammation is associated with monocyte and macrophage activation markers.
- Findings suggest a link between HIV, immune activation, and subclinical vascular inflammation.
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