Affiliation:
1. School of Public Health, Fudan University , Shanghai , China
2. Key Laboratory of Public Health Safety of Ministry of Education, Fudan University , Shanghai , China
3. Yiwu Research Institute of Fudan University , Shanghai , China
4. Taizhou City Center for Disease Control and Prevention , Zhejiang Province , China
Abstract
Abstract
Background
Atherosclerotic cardiovascular disease (CVD) is a common cause of morbidity among people with human immunodeficiency virus (PWH) who initiate antiretroviral therapy (ART). Little is known about the roles of inflammation in atherosclerotic CVD among PWH.
Methods
This cross-sectional evaluation included 178 PWH between 40 and 70 years on stable (>3 months) ART who were derived from the ongoing, prospective cohort for Comparative HIV and Aging Research in Taizhou (CHART), China, from February 2017 to August 2018. Carotid intima-media thickness (cIMT) ≥1 mm was considered as cIMT thickening indicative of atherosclerotic CVD. Plasma inflammation and coagulation biomarkers were quantified by a multiplex bead cytokine assay for 27 cytokines and enzyme-linked immunosorbent assay (ELISA) for soluble CD14 and D-dimer, respectively. We performed a series of multiparametric analyses of biomarkers and developed a composite score for atherosclerotic CVD assessment among PWH.
Results
Of 178 PWH, 53 (30.9%) had cIMT thickening. In multivariable logistic analysis adjusting for CVD and human immunodeficiency virus-specific risk factors, interleukin (IL)-4 (odds ratio [OR] = 19.0; 95% confidence interval [CI], 1.6–226.5), IL-7 (OR = 16.7; 95% CI, 1.8–151.7), IL-10 (OR = 11.9; 95% CI, 2.0–72.1), and D-dimer (OR = 3.1; 95% CI, 1.0–10.1) were significantly associated with cIMT thickening. We also developed a composite score incorporating markers (IL-7, IL-10, D-dimer, and hypertension) that accurately evaluated atherosclerotic CVD.
Conclusions
The associations of IL-4, IL-7, IL-10, and D-dimer with atherosclerosis underscores research needs to further understand the inflammatory mechanisms in the pathogenesis of atherosclerosis CVD among treated PWH. The composite score for atherosclerotic CVD assessment could be useful for risk stratification in PWH.
Funder
National Natural Science Foundation of China
Yiwu Research Institute of Fudan University
Shanghai Municipal Health and Family Planning Commission
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Oncology
Reference42 articles.
1. Do people with HIV infection have a normal life expectancy in the era of combination antiretroviral therapy?;Sabin;BMC Med,2013
2. HIV infection, cardiovascular disease risk factor profile, and risk for acute myocardial infarction;Paisible;J Acquir Immune Defic Syndr,2015
3. Presence, characteristics, and prognostic associations of carotid plaque among people living with HIV;Janjua;Circ Cardiovasc Imaging,2017
4. HIV infection and the risk of acute myocardial infarction;Freiberg;JAMA Intern Med,2013
5. Prehypertension, hypertension, and the risk of acute myocardial infarction in HIV-infected and uninfected veterans;Armah;Clin Infect Dis,2014