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Increased coronary atherosclerosis and immune activation in HIV-1 elite controllers

Florencia Pereyra1, Janet Lo, Virginia A Triant

  • 1Program in Nutritional Metabolism, Department of Radiology, Massachusetts General Hospital, Boston, USA.

AIDS (London, England)
|October 4, 2012
PubMed

Insights

HIV-1 elite controllers show increased coronary atherosclerosis and immune activation. This suggests higher cardiovascular risk despite suppressed viral load, highlighting the need for monitoring in this population.

Area of Science:

  • Cardiovascular Health
  • Infectious Diseases
  • Immunology

Background:

  • HIV-1 elite controllers maintain low viremia but show immune activation.
  • Immune activation in HIV may contribute to cardiovascular disease.
  • Coronary atherosclerosis is a concern in HIV-infected individuals.

Purpose of the Study:

  • To investigate coronary atherosclerosis in HIV-1 elite controllers.
  • To compare atherosclerosis prevalence and immune activation markers between elite controllers and other HIV groups/controls.
  • To assess monocyte activation in elite controllers.

Main Methods:

  • Coronary computed tomography angiography (CTA) was used to assess atherosclerosis.
  • Participants included elite controllers, non-elite controllers, chronic HIV-1 patients on ART with undetectable viral load, and HIV-negative controls.
  • Levels of sCD163, a monocyte activation marker, were measured.

Main Results:

  • Prevalence of atherosclerosis was significantly higher in elite controllers (78%) compared to HIV-negative controls (42%).
  • Markers of immune activation were increased in elite controllers versus HIV-negative controls.
  • sCD163 levels were elevated in elite controllers compared to both chronic HIV-1 patients and HIV-negative controls.

Conclusions:

  • HIV-1 elite controllers exhibit a significant degree of coronary atherosclerosis.
  • Elevated monocyte activation (sCD163) is present in elite controllers.
  • These findings suggest increased cardiovascular risk and immune dysregulation in elite controllers.

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