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Subclinical cardiovascular disease in HIV controller and long-term nonprogressor populations
R M Brusca1, D B Hanna2, N I Wada3
1Johns Hopkins University School of Medicine, Baltimore, MD, USA.
HIV Medicine
|November 16, 2019
Summary
HIV controllers and long-term nonprogressors show similar cardiovascular disease risk as HIV-uninfected individuals, despite elevated inflammatory markers. Further research is needed to fully understand CVD risk in these populations.
Area of Science:
- Immunology and Virology
- Cardiovascular Disease Research
- HIV/AIDS Pathogenesis
Background:
- Individuals with Elite Control (ECs), Viremic Control (VCs), and Long-Term Nonprogression (LTNPs) manage HIV without antiretroviral therapy.
- Despite viral control, these HIV-infected groups may face an elevated risk of cardiovascular disease (CVD) compared to HIV-uninfected individuals.
- Understanding subclinical atherosclerosis and inflammation is crucial for assessing CVD risk in HIV controllers and LTNPs.
Purpose of the Study:
- To evaluate subclinical carotid and coronary atherosclerosis in HIV controllers, LTNPs, and HIV-uninfected individuals.
- To compare inflammatory biomarker levels across different HIV control categories and HIV-uninfected groups.
- To assess the association between HIV control status and the prevalence of atherosclerosis.
Main Methods:
- Carotid plaque presence and intima-media thickness (IMT) were measured in 1729 women and 1308 men.
- Coronary artery calcium and plaque were assessed in a subgroup of men.
- Serum inflammatory biomarkers (sCD163, sCD14, Gal-3, Gal-3BP, IL-6) were quantified and associated with HIV control categories.
Main Results:
- Carotid plaque prevalence and IMT were similar between HIV controllers, LTNPs, and HIV-uninfected individuals.
- HIV controllers and LTNPs exhibited lower carotid plaque prevalence than viremic HIV-infected individuals.
- Coronary atherosclerosis prevalence was comparable across HIV controllers/LTNPs, HIV-uninfected, and viremic HIV-infected men.
Conclusions:
- Subclinical cardiovascular disease (CVD) is similar in HIV controllers, LTNPs, and HIV-uninfected individuals, despite elevated inflammatory markers.
- Elevated levels of certain inflammatory biomarkers (sCD163, sCD14) were observed in controllers and LTNPs compared to HIV-uninfected persons.
- Further research is warranted to fully characterize CVD risk in HIV-infected individuals with elite control or long-term nonprogression.
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