HIV disease, metabolic dysfunction and atherosclerosis: A three year prospective study

Area of Science:

• Cardiology
• Infectious Diseases
• Metabolic Disorders

Background:

• HIV infection is linked to cardiometabolic abnormalities.
• Understanding the progression and causes of these abnormalities is crucial.

Purpose of the Study:

• To investigate the progression and causes of cardiometabolic abnormalities in HIV-infected individuals.
• To assess the impact of antiretroviral treatment on these abnormalities.

Main Methods:

• Recruited three groups: HIV-negative, treatment-naïve HIV-positive initiating treatment, and treatment-naïve HIV-positive untreated.
• Measured carotid intima-media thickness (cIMT), diabetes-related metabolic markers, inflammation, lipid profiles, HDL subpopulations, HDL functionality, and microRNA abundance.

Main Results:

• cIMT increased in untreated HIV-positive individuals but was mitigated by treatment.
• Lower levels of total cholesterol, LDL cholesterol, and apoB were observed in HIV-positive groups.
• Viral load negatively associated with total cholesterol, LDL, HDL, apoA-I, and apoB.
• HIV-positive patients exhibited hypoalphalipoproteinemia and altered HDL subpopulations.
• HDL functionality declined in HIV-negative and untreated HIV-positive groups, but not in treated HIV-positive groups.
• Differences in microRNAs involved in lipid metabolism were found between HIV-positive and negative groups.

Conclusions:

• Cardiometabolic abnormalities in HIV infection are primarily caused by HIV itself.
• Antiretroviral treatment mitigates HIV-associated cardiometabolic changes without negatively influencing key parameters.