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Plasma lipidomic profiling of treated HIV-positive individuals and the implications for cardiovascular risk
Gerard Wong1, Janine M Trevillyan2, Benoit Fatou3
1Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia.
Insights
Human immunodeficiency virus (HIV) and its treatments significantly alter plasma lipid profiles. Specific lipid species can predict cardiovascular disease risk in HIV-positive patients, offering a new screening approach.
Area of Science:
- Cardiovascular disease research
- HIV/AIDS clinical research
- Lipidomics and metabolomics
Background:
- HIV infection and associated antiretroviral therapies increase coronary artery disease (CAD) risk.
- Dyslipidaemia is a key contributor to cardiovascular risk in HIV-positive individuals.
- Understanding plasma lipid profiles is crucial for managing cardiovascular risk in this population.
Purpose of the Study:
- To characterize plasma lipid profiles in treated HIV patients.
- To investigate the association of specific lipid species with cardiovascular event risk in HIV-positive individuals.
- To evaluate the potential of plasma lipids for cardiovascular risk screening in HIV patients.
Main Methods:
- Retrospective case-control study involving 113 subjects.
- Analysis of plasma lipid profiles from 23 HIV-positive cases with prior CAD diagnosis.
- Comparison with 45 age- and sex-matched HIV-positive controls without CAD and 45 HIV-negative healthy volunteers.
Main Results:
- Identified 83 lipid species and 7 lipid classes associated with HIV infection.
- Identified 74 lipid species and 8 lipid classes associated with future cardiovascular events in HIV-positive subjects.
- Risk prediction models using lipid species achieved an AUC of 0.78, outperforming other markers for cardiovascular risk identification.
Conclusions:
- HIV-positive patients exhibit distinct plasma lipid profiles compared to HIV-negative controls.
- Numerous lipid species are significantly linked to elevated cardiovascular risk in HIV-positive individuals.
- Plasma lipids show promise as a novel tool for cardiovascular risk screening in HIV-positive patients.
Background:
The increased risk of coronary artery disease in human immunodeficiency virus (HIV) positive patients is collectively contributed to by the human immunodeficiency virus and antiretroviral-associated dyslipidaemia. In this study, we investigate the characterisation of the plasma lipid profiles of treated HIV patients and the relationship of 316 plasma lipid species across multiple lipid classes with the risk of future cardiovascular events in HIV-positive patients.
Methods:
In a retrospective case-control study, we analysed plasma lipid profiles of 113 subjects. Cases (n = 23) were HIV-positive individuals with a stored blood sample available 12 months prior to their diagnosis of coronary artery disease (CAD). They were age and sex matched to HIV-positive individuals without a diagnosis of CAD (n = 45) and with healthy HIV-negative volunteers (n = 45).
Results:
Association of plasma lipid species and classes with HIV infection and cardiovascular risk in HIV were determined. In multiple logistic regression, we identified 83 lipids species and 7 lipid classes significantly associated with HIV infection and a further identified 74 lipid species and 8 lipid classes significantly associated with future cardiovascular events in HIV-positive subjects. Risk prediction models incorporating lipid species attained an area under the receiver operator characteristic curve (AUC) of 0.78 (0.775, 0.785)) and outperformed all other tested markers and risk scores in the identification of HIV-positive subjects with increased risk of cardiovascular events.
Conclusions:
Our results demonstrate that HIV-positive patients have significant differences in their plasma lipid profiles compared with healthy HIV-negative controls and that numerous lipid species were significantly associated with elevated cardiovascular risk. This suggests a potential novel application for plasma lipids in cardiovascular risk screening of HIV-positive patients.
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