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Plaque burden in HIV-infected patients is associated with serum intestinal microbiota-generated trimethylamine

Suman Srinivasa1, Kathleen V Fitch, Janet Lo

  • 1aProgram in Nutritional Metabolism, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA bINSERM UMRS1138, Cordeliers Research Centre, Paris cInstitute of Cardiometabolism and Nutrition, University Pierre & Marie Curie, Hospital Pitié Salpetrière, Paris, France dUniversity of Rochester School of Medicine, Rochester, New York, New York eCardiothoracic Imaging Division, Department of Radiology, UTSW Medical Center, Dallas, Texas, USA fBiochimie et Hormonologie, Hôpital Tenon AP-HP Paris, CDR Saint-Antoine, Inserm UMR_S938, Université Paris 6-UPMC, Institute of Cardiometabolism and Nutrition, Paris gDepartment of Cardiology, Saint Antoine Hospital, Inserm U938, Université Paris 6-UPMC, Faculté de Médecine Pierre et Marie Curie, Paris, France.

AIDS (London, England)
|January 8, 2015
PubMed
Abstract

Insights

Trimethylamine (TMA) is linked to coronary atherosclerosis in HIV patients, potentially serving as a novel risk factor. This study found TMA, but not TMAO, associated with plaque severity in individuals with HIV.

Area of Science:

  • Cardiovascular Disease Research
  • Microbiome and Metabolomics
  • HIV/AIDS Research

Background:

  • HIV-associated cardiovascular disease is a growing concern, often linked to intestinal dysbiosis and inflammation.
  • Certain gut microbiota metabolites of phosphatidylcholine are known to promote atherosclerosis.
  • The role of these metabolites in HIV-related cardiovascular complications remains under-explored.

Purpose of the Study:

  • To investigate the association between microbiota-derived phosphatidylcholine metabolites and coronary atherosclerosis in individuals with HIV.
  • To determine if serum levels of choline, trimethylamine (TMA), or trimethylamine-N-oxide (TMAO) correlate with coronary plaque features in HIV-infected patients.

Main Methods:

  • Utilized data from a cohort of 155 HIV-infected and 67 non-HIV-infected individuals without prior cardiovascular disease.
  • Assessed coronary plaque characteristics using computed tomography angiography.
  • Measured serum levels of choline, TMA, and TMAO to evaluate their association with plaque features.

Main Results:

  • HIV-infected patients showed a higher prevalence and number of coronary plaque segments compared to non-infected individuals.
  • Serum TMA levels were significantly associated with coronary calcium score, plaque segment counts, and calcified plaque burden in the HIV cohort.
  • No significant association was found between TMAO and coronary plaque features in either group.

Conclusions:

  • The study identifies a novel link between trimethylamine (TMA) and coronary atherosclerosis in the HIV population.
  • TMA may represent a non-traditional risk factor contributing to plaque burden and severity in HIV-infected individuals.
  • Further research is warranted to elucidate the mechanisms underlying TMA's role in HIV-related cardiovascular disease.

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